2024 Leadership Development Workshop Application
Due to limited class size, acceptance into the Leadership Development Workshop is considered competitive. Please submit applications by 5 pm on August 2, 2024. Applications will be reviewed by the LDW Planning Committee and approved by a third-party selection committee, with notification of status delivered no later than August 16, 2024. Please take your time in completing this application so that it reflects the best representation of you and what you can bring to the program as a participant. Questions can be emailed to info@gratiot.org. Cost of the program is $500, and scholarships are available for individuals and non-profit employees.
Basic/Contact Information
Name
*
First Name
Last Name
Email
*
This email will be used to communicate with you in the event of class changes.
Cell phone
*
This number will be used to communicate with you in the event of class changes.
Employer
*
Job title
*
Years at organization
*
Application Questions
Answer each ins 250 words or less.
Briefly describe your work and volunteer experiences, including any leadership roles you have held.
*
Why do you want to be in the Leadership Development Workshop and what is motivating you to apply?
*
As a participant, how will you contribute to the success of the Leadership Development Workshop?
*
Please describe your current leadership style, including areas in which you believe you excel and areas in which you think you need further development.
*
References
Please list a professional reference.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Relationship
*
Scholarship Applicability
Scholarships are available for individuals applying without business financial support or non-profit employees. Contact info@gratiot.org for questions regarding scholarships.
Would you like to be considered for a scholarship?
Yes (scholarship application will be sent to you via email)
No
Emergency Information
If admitted to the class, we will need the following on file.
Dietary needs/Allergens
Accommodations that may be needed for learning
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Anything else we may need to know to ensure a quality learning environment for you?
Statement of Commitment
By signing below, you are indicating that you agree to the following. Should you be accepted into the Leadership Development Workshop, you are committed to attending and actively participating in the monthly sessions, as well as completing any group or individual work assigned in between sessions. Payment (or arrangement of payment) will be made prior to the first course and once payment is made, cost is non-refundable. Acceptance into the program or payments to the program are non-transferable, unless cleared by GYPN Planning Committee. The Gratiot Young Professionals Network committee of the Gratiot Area Chamber of Commerce reserves the right to adjust the Leadership Development Workshop schedule or roster as necessary.
Signature
*
Date
*
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