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Civic Engagement Program Application

Civic Engagement Program Application

Thank you for your interest in applying for the Gila Valley Leadership Network's Civic Engagement Program, a year-long induction into a network of leaders who work together to enhance their abilities to serve and strengthen our community. Gila Valley Leadership is organized in partnership with the Graham County Chamber of Commerce, City of Safford, Town of Thatcher, Town of Pima, Graham County, and Eastern Arizona College with the generous support of numerous businesses and organizations in the Gila Valley, including Double R Communications, Kempton Chevrolet, Mount Graham Regional Medical Center, NatureSweet, OneAZ Credit Union, and the United Way of Graham and Greenlee Counties.
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    Please complete each section below. All fields are required. Applications are due by 5:00 pm on Sunday July 27th. Interviews will take place on Friday, August 8th and Saturday, August 9th. For assistance in filling out this application online, set an appointment with Camilla Gary, Staff Assistant at the Graham County Chamber of Commerce by calling (928) 324-9112‬. The committee will issue final decisions by 5:00 pm on Monday, August 11th.

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    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
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    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
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    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
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    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
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    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
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    • Western Sahara
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    Please list any limiting disability, temporary or permanent, any allergies, reactions to medications, dietary restrictions, or other medical limitations (please note that this section is to better serve you, and holds no bearing whatsoever on your selection to participate in the program):
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    Please Select
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    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    For help writing a resume, you may contact Eastern Arizona College's Career Service Center at alison.villalobos@eac.edu or ‭(928) 428-8609‬.
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    To qualify for induction, cohort members are expected to participate fully in the entire program, and attend all XXX Leadership Days, the Phoenix Delegation, and the induction ceremony. Delegates will also be asked to provide 20 hours of community service as part of their cohort year and a final report on their experience. Generally, participation requires one full day per month (8 am - 6 pm) for 10 months and a moderate amount of additional personal time working on cohort community service projects. Please examine the schedule at-a-glance below to determine if you can fully participate in the program.

    Cohort 20 Schedule at a Glance, 8:00 am - 6:00 pm, Graham County Chamber of Commerce, 1051 W Thatcher Boulevard, Safford, Arizona, 85546:


    Day 1: Thursday, August 28, 2025
    Day 2: Thursday, September 25, 2025
    Day 3: Thursday, October 23, 2025
    Day 4: Thursday, December 4, 2025
    Day 5: Thursday, January 22, 2025
    Phoenix Delegation: Wednesday, February 25th - Friday, February 27th
    Day 6: Thursday, March 26, 2026
    Day 7: Thursday, April 23, 2026
    Day 8: Thursday, May 28, 2026
    Induction Ceremony: 6:00 pm, Thursday, June 25, 2026

    If you cannot commit to these dates, please do not apply until you can fully commit to participating in the program.

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    Gila Valley Leadership delegates or their employers are responsible for dues of $500.00. Scholarships are available based upon financial need and the availability of scholarship funds. Full payment of tuition is due no later than 5:00 pm on September 30, 2025.

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    I understand that my participation in the Gila Valley Leadership Network's Civic Engagement program may expose me to above normal risks due to travel, touring of area agriculture, mining, and government facilities, and participation in team building exercises and encounters with other natural and man-made hazards. I also understand that although the Gila Valley Leadership Network's Civic Engagement Program (a leadership development program administered by the Graham County Chamber of Commerce) will take precautions to provide proper instruction and supervision, it is impossible to guarantee absolute safety. I also understand that I share the responsibility for safety during the program and I assume that responsibility. If at any time I feel uncomfortable with an activity, I can exercise my right to withhold participation. I have in place personal health insurance and am responsible for any medical expenses that may arise as a result of accidental injury during participation. I understand that parts of the program may be physically or emotionally demanding. I affirm that my health is good, and that I am not under a physician’s care for any undisclosed condition that bears upon my fitness to participate. I understand that each participant must assume the risk of physical injury that could result from any of the activities. I hereby release Gila Valley Leadership and the Graham County Chamber of Commerce, its staff members, board and committee members, volunteers, financial supporters, and general members from all liability for any injury to me from participation in the Gila Valley Leadership Network's Civic Engangement program. I understand that these terms shall serve as a release of liability for my heirs, executors, administrators, and all members of my family. I understand that photos and videos of my face and my name will appear on websites, press releases, news organizations, and newsletters, and I agree to release my image and name.

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