CANDIDATE APPLICATION-2025

Tuition to be Paid by:*

ParticipantEmployerSponsor
SESSIONS
- Orientation and Ropes Course
- Agriculture
- County Challenges
- News Media
- Industrial Development
- Wellness/Health
- Education
- Government
- Legal Systems
- Graduation
PARTICIPATION

Canditates are expected to participate in all elements of the Leadership Columbiana County Program, including but not limited to the following:
- Regular attendance at all one-day classroom sessions monthly
- Scheduled group activities
- Participation in a Community Service Project
- Reading Assignments
APPLICANT COMMITMENT

By submitting this form to the Leadership Columbiana County Program Selection Committee, I am making a commitment to participate in all activities related to the program, and will devote the time and resources necessary to complete the program.
Signature*

Powered by Jotform SignClear
EMPLOYER COMMITMENT

The applicant listed above has full support and endorsement of our organization and will be given the time necessary to participate in and to complete the Leadership Columbiana County Program.
Employer Signature

Powered by Jotform SignClear

Please explain your interest in the LCC Program and what you would like to accomplish:*
What do you feel are the next three most notable opportunities in our area?*
What do you feel needs to be done to develop one of these opportunities?*
Please provide a brief statement about yourself. You may comment on professional achievements, community service or a combination of both. (Please note, your response may be used in LCC publicity if you are selected)*
High School:
Graduation Year:
College:
Graduation Year:
Degree:

Please list previous employment, starting with the most recent. (Include active military service)
Company Name:
Position/ Title:
Supervisor Name:
Phone Number
Please enter a valid phone number.
Date Employment Started

MonthDayYear
Date
Date Employment Ended

MonthDayYear
Date
Company Name:
Position/ Title:
Supervisor Name:
Phone Number
Please enter a valid phone number.
Date Employment Started

MonthDayYear
Date
Date Employment Ended

MonthDayYear
Date
Company Name:
Position/ Title:
Supervisor Name:
Phone Number
Please enter a valid phone number.
Date Employment Started

MonthDayYear
Date
Date Employment Ended

MonthDayYear
Date
Director: Amanda Frost

President: Lori Colian

LeadershipColumbianaCounty.org
Application due by August 31st

Tuition ($1,500) due prior to first class

Questions? Call 330-362-4433
Leadership Columbiana County

PO Box 491

Columbiana, OH 44408
Should be Empty:

CANDIDATE APPLICATION