LEADERSHIP PUTNAM

Complete this application to be considered for the Leadership Putnam class of 2026.

Once you begin this form, completion is required. You are not able to save your work.

Deadline to apply is June 20, 2025.
Incomplete or late applications will not be considered.

If you have questions, please contact Angie Wells, Leadership Putnam Director at the Cookeville - Putnam County Chamber of Commerce.
Phone: 931-526-2211
Email: awells@cookevillechamber.com

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Who recruited you or encouraged you to apply to Leadership Putnam?*

Age*

Race*

Gender*

Employment Information*

Business NameTitle/Position

Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Work Phone Number

Upload Resume*

Activities/Volunteerism: Please list in order of importance to you, up to five community, civic, professional, business, religious, social, athletic, or other organizations of which you are or have been a member.*

What have you accomplished as a result of these activities that you feel has benefited the community or its residents? (5 sentences or less)*

How many hours do you devote to these activities each month?*

Have you been as involved in the community as you would like to be? If not, what are some of the barriers to your involvement? (5 sentences or less)*

What do you hope to gain from your Leadership Putnam experience that will benefit you and our community? (5 sentences or less)*

Please identify a particular issue, challenge, or problem you feel is critical in Putnam County. Briefly explain your concern and involvement in finding a solution to this issue. (5 sentences or less)*

Initial below if you and your employer are willing to make this commitment*

*Absenteeism will result in the participant being dropped from the program. If you are unable to make this time commitment, it is not in your best interest to apply at this time.

How long have you lived in Putnam County?*

List up to 3 references including name, relationship, company, address, phone number, and email*

Commitment:

To graduate from Leadership Putnam, only two excused absences from any program day is possible. Attendance at the opening retreat is mandatory. Typical schedule is as follows:

Opening Retreat: August 7th and 8th
Thursday night dinner and Friday teambuilding. This is not overnight.
Program Days: September through May.
These are full 8-hour days, usually the first Thursday of each month. There will be no program day during December.
Below is a list of TENTATIVE dates for program days.
- Human Needs & Services Day - September 4th
- Education Day - October 2nd
- Environment & Agriculture Day - November 6th
- Economic Development Day - January 8th
- Local Government Day - February 5th
- State Government Day - March 4th
- Healthcare Day - April 2nd
- Quality of Life Day - May 7th
- Graduation: tentatively, May 21st
Individual & Group Projects:
- Class members must gain individual points through participation in community events.
- Class members will be assigned to a group. The group will complete a project and present their outcomes and accomplishments on the last program day.

By signing my name, I agree to all terms as listed by Leadership Putnam:

This application does not secure my spot in the program.
Members will be chosen on a case by case basis of availability.
I will be notified of my acceptance by June 27.
Upon acceptance, a non-refundable tuition fee of $760 will be due and paid no later than July 9th.
To graduate from Leadership Putnam, only two excused absences from any program day is possible. Attendance at the opening retreat is mandatory.

Signature*

Attach Headshot*

Provide Professional Bio in third-person (3-5 sentences)*

Class of 2026 Application