2023 Leadership Lafayette Application

I have read the information and agree to the terms listed on the Chamber of Commerce's website (https://oxfordms.com/chamber-of-commerce/programs-and-events/leadership-lafayette/)*

I agree

Please review the tentative schedule for 2023 and check the option below:

Thursday, January 19, 2023 (ATTENDANCE REQUIRED, class participants must attend opening session)
Thursday, January 26, 2023 (ATTENDANCE REQUIRED, class participants must attend team building session)
Thursday, February 9, 2023
Thursday, March 2, 2023
Thursday, April 13, 2023
Thursday, May 4, 2023
Thursday, June 8, 2023
Thursday, July 13, 2023
Thursday, August 3, 2023
Thursday, August 31, 2023 (ATTENDANCE REQUIRED, class participants must attend graduation)

I have reviewed the tentative session schedule above and understand the time commitment.

Personal Information:

Full Name*

First NameLast Name

How would you prefer to be addressed?

This can include preferred pronouns, preferred name, etc.

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone Number*

E-mail*

example@example.com

How long have you lived in Lafayette County?*

Are there any accommodations you might need in order to fully participate in this program?

ie - vegetarian

Employer*

Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Work Phone Number*

Please enter a valid phone number.

Title/Position*

Please upload your resume here. *

Please upload two letters of recommendation. *

One personal and one professional

Questions and Details:

Cover Letter: Please tell us why you would be a good fit for Leadership Lafayette. *

What characteristics do you think all leaders have and why?*

Some examples may include: integrity, innovative, good listener, etc.

Please give examples of how you may embody the characteristics listed above.*

Tell us about a time that you took leadership in solving a problem. This could be at work, in a volunteer position, or in your personal life.*

How did you hear about Leadership Lafayette? *

Tuition for the Leadership Lafayette Program is $500. If accepted into the program, tuition must be paid prior to the first session. Please indicate your source of payment.*

Non-profits and individuals may qualify for partial scholarship funding. For information on scholarship opportunities or payment options contact pam@oxfordms.com

In order to successfully complete and graduate from Leadership Lafayette, your FULL participation is required. You will be required to attend monthly sessions and actively participate in a group project. YOU CANNOT MISS MORE THAN ONE (1) SESSION (or two 1/2 sessions). Please check all the boxes that apply.*

Will you be able to fulfill the commitment to this program?Do you have the support of your employer for the time required to participate in this program?Do you and your employer understand that you will have to participate in a community project outside of the regular class schedule?I UNDERSTAND THE IMPORTANCE OF THIS COMMITMENT AND AGREE TO ATTEND ALL SCHEDULED SESSIONS.

The Oxford-Lafayette Chamber of Commerce, EDF, or any of its affiliates and/or agents will not be held responsible for any of the intentional or negligent acts arising from any persons associated with the Leadership Lafayette program. As a participant in the Leadership Lafayette program I agree to hold the Oxford/Lafayette Chamber of Commerce, EDF, and its associates or agents harmless and indemnify them against any losses or lawsuits arising while participating in the program.*

I agree

I will attend all sessions unless an emergency situation arises. In the event that I am unable to attend a session (or a portion of), 24 hour notification will be given to the Leadership Lafayette director Pam Swain.*

I agree

I understand that attendance is required at all sessions, and that attendance is mandatory for the Orientation Sessions-Part I and Part II, and the closing project presentation/graduation banquet.*

I agree

I understand that I cannot miss more than ONE SESSION(or two 1⁄2 sessions) to graduate. If I miss more than one session or two 1⁄2 sessions I will not be able to graduate from the program.*

I agree

I understand that no portion of Leadership Lafayette tuition is refundable.*

I agree

I understand that cellular phones and similar devices are an interruption to the Leadership Lafayette sessions and will not be allowed during the sessions.*

I agree

I understand that the success of Leadership Lafayette is dependent upon my total commitment, therefore, I understand that tardiness and early departure from Leadership Lafayette sessions is not acceptable.*

I agree

I understand that active participation is expected of me in a group community project, which will require my time outside of the regularly scheduled program sessions.*

I agree

Signature