Cincy Next 2024, Class 11 Application

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Admission is competitive and space is limited. Please submit your application online as soon as possible for the best opportunity to be accepted. If you need to step away from your application and finish it at a later date, you can click the "Save & Continue Later" button at the bottom of the application and you will receive an email with a link to continue at your convenience.

To complete your application, you will need to supply a reference. Please send your reference this form and have them submit it by the application due date (October 16, 2023).

There will be a non-refundable $50 application fee due at the time of submission. Once you hit the submit button, you will be automatically redirected to make your payment. Your application will not be considered complete or reviewed until we receive this payment.

If you have any issues submitting your application or processing your payment, please contact Andrea Mersmann at amersmann@cincinnatichamber.com.

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Name* This field is required.

First Name

Last Name

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Primary Email Address* This field is required.To be used throughout the class.

example@example.com

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Personal Email Address

example@example.com

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Years of Professional Experience* This field is required.

2-8 Years

>8 Years

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Your LinkedIn URLPlease write N/A if you do not have one.

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Primary Phone Number* This field is required.

Please enter a valid phone number.

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Secondary Phone Number

Please enter a valid phone number.

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Home Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Country of OriginOPTIONAL: Question is designed to help us achieve a diverse program

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Date of BirthOPTIONAL: Question is designed to help us achieve a diverse program

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Race/EthnicityOPTIONAL: Question is designed to help us achieve a diverse program

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Other

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What are your pronouns?OPTIONAL: Question is designed to help us achieve a diverse program

She/her

He/him

They/them

I prefer not to say

Other

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Are you a Veteran?OPTIONAL: Question is designed to help us achieve a diverse program

YESNO

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Company/Organization* This field is required.

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Job Title* This field is required.

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Company Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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What is the nature of the business/organization? * This field is required.

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Do you have full support from your employer for the tuition financial commitment required to take participate in the program?Financial commitment from organization is not required. There is an option for self-pay or a combination of self and organization pay.

YESNO

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Do you have full support from your employer for the required time away from work to take participate in the program?

YESNO

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Your Supervisor name:

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Your supervisor email:

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Current CompanyList name of company, industry, your role, and years worked.

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Previous Company #1List name of company, industry, your role, and years worked.

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Previous Company #2List name of company, industry, your role, and years worked.

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Grants: Partial grants up to $1,000 may be available for small non-profits, entrepreneurs, or those self-paying base on need. Would you like to apply for grant money?

YESNO

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If yes to applying to grant, enter grant amount requested:

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If yes to applying to grant, please briefly explain why you are requesting financial assistance and how you think your participation in the program would provide a distinct and positive addition to the class.

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If you do not receive a grant requested, will you still be able to take part in the program if accepted?

YESNO

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How many years have you lived/worked in the Cincinnati region? * This field is required.

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Have you previously applied to or participated in a Cincinnati Regional Chamber or other community leadership program (e.g., Leadership Cincinnati, Urban Leaders Program, Leadership Northern Kentucky)?* This field is required.

YESNO

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If yes, which program(s) and what year(s)?* This field is required.

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Please share by whom you were referred or how you heard about the Cincy Next program.

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Are you aware of others from your organizations who are applying for the program?* This field is required.

YESNO

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Do you know anyone else applying for Cincy Next 2024, Class 11? If yes, what is your relationship to them?Knowing someone else applying does not lessen chances of being accepted.

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Relevant Leadership Experience & Community Involvement* This field is required.Please list membership, leadership roles and/or awards in school, community, civic, professional, religious and social organizations that have been of significance to you. Include years/dates. Note that previous involvement etc., is not a requirement for applicants.

0/1500

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Briefly describe a significant accomplishment (can be professional, personal, communty, etc.).* This field is required.Be specific. Describe the situation, actions taken, results and your leadership role.

0/1500

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Do you currently lead a team?* This field is required.Be specific. Share your role and how large the team is that you formally lead. If you do not formally lead a team but have led projects, etc., please share that. Note that leading a team is not a requirement for applicants.

0/1500

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How do you respond when being challenged regarding something that is prohibiting progress? Share a specific example.* This field is required.The challenge could relate to the method and/or results used for a project, an opinion shared, an interaction with a client, etc.

0/1500

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Describe a failure that had a big impact on your personal or professional life, and how that experience changed the way you operate/what you learned.* This field is required.Be specific and do not only generalize. Everyone experiences setbacks, challenges and/or failures. Please share yours.

0/1500

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Why should you be selected for Cincy Next? * This field is required.Acceptance into Cincy Next is selective. Please include what you can contribute to the program and what you hope to gain from the experience.

0/1500

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What are your (up to 3) professional goals and what do you need to do to reach them?* This field is required.Keep in mind how they relate to going through Cincy Next.

0/1500

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As mentioned, Cincy Next is competitive. Please share something else that will help else get to know you better as an individual. * This field is required.This can be personal or professional, serious, or fun.

0/1500

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Participants of the program may be asked to engage in pre-class assignments that will require approximately 1-2 hours during the weeks prior to each session. Will you be able to contribute the time needed to fulfill these assignments?* This field is required.

YESNO

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Participants of the program will be required to take part in a small group project that will require approximately 3-5 hours/month outside of the sessions.Will you be able to contribute the time needed to fulfill this requirement? * This field is required.

YESNO

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I understand the purpose of Cincy Next, the attendance requirements, and the time and energy necessary to make it a successful experience. I will commit fully to the program and will block my calendar on the following dates to make this a priority.* This field is required.Your participation is critical for the success of the program. This program will be offered in person and hosted at multiple locations throughout the region. The curriculum for Cincy Next includes a kickoff reception, graduation ceremony, overnight retreat, 6 full-day sessions, and a project session. Cincy Next Class 11 (2024) Dates Opening Reception: March 27, 2024 3-6 p.m. Overnight "Venture Out!" Retreat at Camp Joy (REQUIRED): April 18 -19. 2024 Volunteer Small Group Session: April 24, 2024 3-5 p.m. Session 1: Wednesday, May 15, 2024 8:30 a.m.-4:30 p.m. Session 2: Wednesday, June 26, 2024 8:30 a.m.-4:30 p.m. Session 3: Wednesday, July 24, 2024 8:30 a.m.-4:30 p.m. Session 4: Wednesday, August 21, 2024 8:30 a.m.-4:30 p.m. Session 5: Wednesday, September 18, 2024 8:30 a.m.-4:30 p.m. Session 6: Wednesday, October 16, 2024 8:30 a.m.-4:30 p.m. Graduation Celebration: October 30, 2024 5-8 p.m.

YESNO

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Please upload your preferred headshot.* This field is required.Please Title: Last Name, First Name, CincyNext10. These are for program use only (e.g., bio book, social media graphics, etc.).

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Signature* This field is required.Your signature verifies your submission. When you hit submit, you will be redirected to pay your $50 application fee. As a reminder, your application will not be considered complete or reviewed until this payment is received.

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