Course Registration Form

Class of 2026 MLI Application

Application Due by October 17, 2025
Full Name

First NameMiddle NameLast Name
E-mail
example@example.com
Cell Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date

MonthDayYear
Nationality
Ethnicity
Race
Zip code where you grew up in
Employer
Facebook
Instagram
TikTok
Twitter
Linkedin
Describe your last public leadership experience - if any. (Please answer in 3–5 complete sentences)
Have you participated in a leadership program in the past? Which? (Please answer in 3–5 complete sentences)
If given the opportunity, what public leadership role do you see yourself for the near future? (Please answer in 3–5 complete sentences)
In your view, how does public change happen? (Please answer in 3–5 complete sentences)
Describe the state of the current political process (Please answer in 3–5 complete sentences).
Please indicate if you are being recommended by an MLI Alumn and include their name.
If yes, please add their name below.
What is your preferred means of communication?
Should be Empty:

Class of 2026 MLI Application