2020-21 Leadership Arlington Adult Application

Leadership Arlington is a non-profit 501(c)3 organization whose mission is focused on the development of the next generation of community leaders. The program seeks to identify potential community leaders, educate them regarding civic engagement and leadership opportunities, and provides the graduate, and their sponsoring company, access to a wide network of like-minded professional leaders. Leadership Arlington is committed to identifying leaders from various geographic, ethnic, occupational, and economic segments of Arlington.

Please complete the application below to be considered for the

2021-22 Adult Leadership Arlington class.

Applications are due July 31, 2021 and are charged a fee of $650.

Invoice information must be provided or application will not be considered.

Applications being paid by founding Leadership Arlington organizations will have an application fee of $600 up until July 31, 2021.

ALL APPLICANTS WILL BE DEFERRED UNTIL THE FOLLOWING YEAR IF PAYMENT IS NOT RECEIVED.

My employer has reviewed the Employer Commitment Form and is agreeing to my participation -- OR -- I am self-employed/agree. *

I agree and accept

I have reviewed and agree to sign the Photo Release Form.

I agree and accept

Name *

First Name Last Name

Name of Spouse (if applicable)

First Name Last Name

Home Address *

Street Address

Street Address Line 2

City State

Zip Code

Cell Phone *

Alternate Phone Number *

Personal Email *

Date of Birth *

Date

T-Shirt Size *

Gender *

Do you have any food allergies or food restrictions?

Have you participated in the Youth LA Program or have you had a family member participate in the Adult LA Program? (If so, please list their name)

How long have you lived in Arlington *

Address you prefer to receive correspondence? *

Education

Employment History

Current Employer *

Title *

Is your business/organization sponsoring you? *

Your Business Email *

Business Phone *

Business Fax

Business Address *

Street Address

Street Address Line 2

City State

Zip Code

Invoice Address and Contact *

Street Address

Street Address Line 2

City State

Zip Code

Accounts Payable Name/Attention to: *

Invoice Email: *

APPLICANT COMMITMENT

Leadership Arlington is an interactive learning experience that requires the candidate to make a serious commitment to fully participate in all aspects of the program.

APPLICATION AND TUITION MUST BE RECEIVED BY JULY 31, 2021. Once participants are selected, tuition must be paid by July 31, 2021. Tuition is non-refundable after August 5, 2021. A $50 processing fee will be deducted from each tuition refund. Failure to meet payment deadline will result in candidate not being admitted to the class. Alternate financial arrangements will be considered on a case‐by‐case basis.
A limited number of scholarships are available. Request for scholarship should be made in writing to the Treasurer at treasurer@leadershiparlingtontx.org and will be awarded on a first-come, first-served basis. If a scholarship is awarded and the participant fails to complete the program, a refund of that scholarship (pro-rated based on length of program completed) will be due to Leadership Arlington within 6 months of the drop date.
Attendance at the opening retreat is mandatory. Failure to attend the opening retreat in its entirety will result in participant being deferred to next year’s class. Refunds will not be provided after August 5, 2021.
Attendance at all eight (8) monthly sessions and the Graduation Ceremony is required to receive graduation credentials. Personal emergencies, illness and catastrophic events will be evaluated on an individual basis.

I understand the above commitments and agree to abide by the program guidelines if selected to participate.

Signature *

2021-22 Adult Application (INVOICE)