Burleson Chamber Ambassador Application

Leadership Burleson
Application

"Building a better Burleson of tomorrow by
cultivating the emerging leaders of today."

Leadership Burleson is a Burleson Area Chamber of Commerce program for individuals who work in and around the City of Burleson, Texas. Participants from diverse backgrounds gain an expanded knowledge of our community; to build relationships with other; to engage with political, civic and business leaders; and to create opportunities for a more active and effective role of leadership and volunteerism in our community.

To ensure the quality of the Leadership Burleson experience, only one class is offered per year and class size is limited.

Candidates for the program meet the following criteria:
- Serve in a leadership capacity in organizations related to their profession, academic institutions or other professionals’ organizations.

- Are committed to personal growth and career advancement while serving the Burleson community.

- Have been active in volunteerism and want to strengthen leadership practices to enhance their potential.

- Are considered by peers or employers as emerging leaders in business, government, non-profit, service sectorsor as an entrepreneur.

- Aspire to become actively engaged in Burleson through decision making roles on community boards, city commissions and non-profit volunteerism roles.

- Possess high standards of personal quality and integrity.

- Leadership Burleson will require participants to attend ALL MEETINGS and ALL OUTINGS. By submitting this application, participants agree they can and will commit the time required for the program. If employed, the participant has the full endorsement of their employer to commit the time required as a participant of Leadership Burleson.

If accepted, the Program Fee is $500.00.

This fee covers expenses for all
Leadership Burleson meetings and outings.

Applicant: *

First Name Last Name

Nickname:

Spouse's Name:

Home Address:

Street Address

Street Address Line 2

Business Name: *

Business Address: *

Street Address

Street Address Line 2

Business Phone: *

Area Code Phone Number

Cell Phone:

Area Code Phone Number

E-mail: *

Business Website / Social Media:

Membership in the Burleson Area Chamber of Commerce is required to be a participant in the Leadership Burleson Program. Are you or is your company an active Chamber Member?

Yes No

Leadership Burleson will require you to attend ALL monthly meetings in order for you to complete and receive full benefit of the programs. Do you agree to this level of participation?

Yes No

Does your Employer agree and fully endorse this level of participation?

Yes No

Signature: *

Clear

Employer Signature (to acknowledge full endorsement): *

Clear

Please provide a brief summary of your professional career, experience and/or education.

Please list any community, civic, professional, education and religious organizations in which you have been involved. If you are new to Burleson, please list activities in your previous community.

What is one issue facing Burleson that is a personal concern to you? How would you use your leadership skills to benefit the community?

Why do you want to participate in the Leadership Burleson Program?

What specific skills and/or knowledge do you hope to receive through your participation with Leadership Burleson?

Participant Signature:

Clear