2026-2027 Leadership Development Workshop Application
Due to limited class size, acceptance into the Leadership Development Workshop is considered competitive. Please submit applications by 5:00 pm on Friday, November 20, 2026. 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 December 15, 2026. 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 chamberdirector@gratiot.org. Cost of the program is $350, 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.
Format: (000) 000-0000.
Employer
*
Job Title
*
Years At Organization
*
Application Questions
Please answer in 250 words or less
Briefly describe your work and volunteer experiences, including any leadership roles you have held.
*
Why are you interested in participating in the Leadership Development Workshop?
*
How do you hope to use what you learn through this program to benefit your organization or the Gratiot County community?
*
Please describe your current leadership style, including areas in which you believe you excel and areas in which you think you need further development.
*
The Leadership Development Workshop requires attendance at all four sessions and active participation in group discussions and activities. Are you able to make this commitment?
Yes
No
If there are any anticipated scheduling conflicts, please detail below:
References
Does your supervisor support your participation in this program?
Yes
No
Self-Employed
Please list a professional reference below:
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship
*
Scholarship Applicability
Scholarships are available for individuals applying without business financial support or non-profit employees. Contact chamberdirector@gratiot.org for questions regarding scholarships.
Would you like to be considered for a scholarship?
Yes (Scholarship Application will be sent via email)
No
Emergency Information
If admitted to the class, we will need the following on file.
Dietary Needs/Allergens
Learning Accommodations
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Any Additional Information for a Quality Learning Environment?
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
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Continue
Continue
Should be Empty: