LEADERSHIP NORTHWEST APPLICATION

LEADERSHIP NORTHWEST

CLASS 31 APPLICATION 2024-2025
All applications are confidential. Please provide sufficient information for the selection committee to make a determination of your eligibility based on your skills, professional experience, community involvement, and personal commitment.
All applications are due by July 31, 2024 to the NWOKC Chamber, PO Box 144, Bethany, OK 73008 lnw@nwokc.com
PERSONAL DATA
FULL NAME
CELL PHONE
HOME ADDRESS
CITY/ZIP
PERSONAL EMAIL
example@example.com
HOME PHONE
EMPLOYMENT INFORMATION
CURRENT EMPLOYER
JOB TITLE
Address

BUSINESS ADDRESS

Street Address Line 2

CITY/ZIPState / Province

Postal / Zip Code
WORK EMAIL
example@example.com
WORK PHONE
TYPE OF BUSINESS
SUPERVISOR
PERSONAL BIO - can include education, previous employment, family, interests
ORGANIZATION & COMMUNITY INVOLVEMENT - Please list any professional, community, civic, religious, political, social, athletic, or other organizations in which you have been active and your role in them
How have you contributed to the mission or growth of one of those organizations
What cities or communities do you serve? (select all applicable)

BethanyWarr AcresThe VillageNichols HillsOklahoma CityYukon/Mustang/Piedmont/El RenoMoore/NormanEdmond/DeerCreekMidwest City/DelCity/ChoctawOther
How did you learn about Leadership Northwest?

Northwest OKC ChamberMy EmployerColleague/CoWorkerFriend/FamilyOnline/Social MediaNews StoryOther
What is your primary motivation for taking the class?

Leadership DevelopmentBusiness DevelopmentCivic EngagementNetworkingPersonal GrowthOther
What is a personal leadership goal you hope to advance?
SIGNATURE

Clear
Date Submitted
Please provide a professional photo and two letters of recommendation - Suggested one from an employer and one from a community contact.

A commitment to LNW includes mandatory attendance at class one day each month, September - May and participation in a Class Leadership Project. Employer's approval of this commitment is required.

Tuition is $800 for NWOKC Chamber Members, $1,000 for Non-members. Tuition can be broken into payments. No additional fees are required for books, meals, etc.
NWOKC CHAMBER PO BOX 144 BETHANY OK 73008

OR EMAIL TO lnw@nwokc.com
Should be Empty:

LEADERSHIP NORTHWEST

PERSONAL DATA

EMPLOYMENT INFORMATION

NWOKC CHAMBER PO BOX 144 BETHANY OK 73008