A2Y Leadership Application

A2Y Leadership Application
The unique quality of life we enjoy in the Ann Arbor / Ypsilanti area is a result of strong leaders and responsible citizens.

A2Y Leadership, offered by the Ann Arbor / Ypsilanti Regional Chamber, presents a rare opportunity for individuals to develop their leadership strengths, gain direct access to local decision makers, and define their roles as true stewards of the community.
Name*

First NameLast Name
Preferred Name
Business Email*
example@example.com
Title
Employer*

Contact Information
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Number*
Please enter a valid phone number.
Cell Number
Please enter a valid phone number.
Personal Email
example@example.com

Your Interest

Each program year we try to customize the content of the program based on the interests of the participants. Please use an additional sheet of paper to answer the following questions.
What are the reasons you want to participate in the A2Y Leadership program?*
What do you think are the significant issues facing the Ann Arbor / Ypsilanti region?*
What responsibility do individuals have to help solve community problems?*

Agreement
Tuition & Commitment
The tuition for the A2Y Leadership program is $1,650 for Chamber Members and $2,150 for Prospective Chamber Members. The tuition covers program costs for an Impact ticket, Orientation, the Retreat, and the eight monthly sessions, including meals and most transportation costs from the program’s point of origin.

A2Y Leadership requires commitment, prioritization and dedication. Each participant is required to attend every session from the orientation to the retreat and the monthly class sessions. If a class member is absent in excess of two (2) sessions, they forfeit their eligibility to graduate with this years class.

An applicant’s place is secured in the class as soon as he/she is notified in writing of his/her acceptance, and when tuition is paid in full. Applicants are encouraged to send payment with their applications. Full tuition payment is due by October 8, 2025, the day of Orientation. If the applicant submits their application after October 9th, tuition payment must be sent with the application.

If payment is not received, or if arrangements to make necessary payment(s) are not made with the Chamber, the applicant’s place in the class will not be secured and may be given to another. All requirements stated herein apply to scholarship recipients as well as non-scholarship recipients. If an applicant must cancel or forfeits his/her place within the class, a $100 cancellation fee will be charged at the discretion of the A2Y Regional Chamber. If an applicant cancels within 10 days prior to the Retreat, one-half of the full tuition will be forfeited. If an applicant cancels after the Retreat, the entire tuition will be forfeited and no refunds will be granted. Thank you for your understanding.
I agree with the terms and commitment above:*

Clear
Scholarship Support
A limited number of partial scholarships are available through the A2Y Leadership Scholarship Program. Requests for financial assistance do not affect consideration for participation. Scholarship applicants must be A2Y Regional Chamber members and preference will be granted first to employees of non-profit organizations. To be considered for financial assistance, you must complete a Scholarship Application and submit it with the A2Y Leadership Program Application.
Are you requesting financial assistance?

YesNo

Scholarship Application
Selection Criteria:

1. Scholarship applicants employed by a 501(c)3 non-profit will receive preference.

2. Scholarship applicants are required to submit a completed program application along with this application, as the information will be used to evaluate the request. If you do not receive a scholarship and cannot make the financial commitment, the application fee will not be refunded.

3. Recipient’s applications must be received at the Chamber offices by September 27, 2025. Scholarship applications received after this date will not be eligible to receive a scholarship.

Final selection of applicants will be made by October 1, 2025. Scholarship recipients will be notified by email.

The balance of the tuition must be paid by the orientation session on October 9, 2025. If a scholarship recipient is unable to attend the program, the scholarship shall be given to an alternate individual chosen by the scholarship committee.
NOTE: On the previous page, you answered "NO" to "Are you requesting financial assistance?".

Please select "NEXT" to continue to the next page of the registration.
I understand and agree to the terms of scholarship selection and will abide by them.

YesNo
Does your organization have a 501(c)3 non-profit designation

YesNoOther
Does your organization have a budget for staff development?

YesNo
If you answered yes to the previous question, how much is your organizations's staff development budget?
What level of scholarship assistance do you need?
What is your organization’s annual budget?
Describe why you should be chosen to receive a scholarship for the Leadership A2Y program (use a separate sheet).

Executive Approval

If you are not the CEO, please complete the section below with the CEO.
The applicant has my approval to apply for a scholarship for the A2Y Leadership program. If chosen as a recipient, they have my permission to participate:*

YesNoN/A
CEO Name

A2Y Leadership Application

Contact Information

About You

Your Interest

Agreement

Scholarship Support

Scholarship Application

Executive Approval

Registration