Information Regarding this Application
Thank you for applying to enroll in our Flagship program! Please complete the application below. Fields with an asterisk (*) are required.
Please request the Employer Statement of Support from your employer and contact your reference promptly to avoid a delay in submitting your application. Copy this link for the Employer Statement of Support. Copy this link for the Character Reference form. (If you are self-employed, you do not need an Employer Statement of Support.) You should email the appropriate link to your employer or your character reference contact so they can fill out the forms right away. Once they complete the forms, PDF copies will be emailed to you. Please have your Employer Statement of Support and Character Reference forms ready to upload. You are required to attach the necessary forms in order to submit your Flagship application.
Vaccination Status
Leadership Winston-Salem requires proof of COVID-19 vaccination for all program participants (class members, committees, staff, board, and volunteers). If selected into the program, we require a copy of your updated vaccination card or other proof of vaccination. If you have a religious or medical exemption, please notify the Flagship Program Director, April Garner, at april@leadershipws.org.
Save Your Progress
If you need more time to complete the form, you can save it at any time by clicking the "Save" button at the bottom of the page. You can return to finish the form at your convenience.
When you click "Save," you will be prompted to create a Jotform account, but if you do not wish to do so, click the "Skip Create an Account" link at the bottom of the window. You will be prompted for an email so they can send you the link without creating an account.
If you have any technical issues with this form or its submission, please contact the LWS Administrative and Technology Director, Jared Steward, at 336-723-1002 x1200 or admin@leadershipws.org.
Application Deadline
This application is due no later than June 22, 2022.