2026 L.E.A.D. Bolivar Application

ABOUT THE PROGRAM
L.E.A.D. Bolivar – Leadership, Education, Action, and Development – identifies, educates, and connects emerging leaders across Bolivar County through monthly classroom learning and experiential tours. Participants deepen their understanding of local issues, strengthen professional and community networks, and build servant-leadership skills that create lasting impact.

This program welcomes professionals at any career stage, including emerging leaders, mid-level professionals, seasoned leaders, entrepreneurs, and small-business owners. There is no age limit.
PROGRAM SCHEDULE
Dates: February – November 2026

Meetings: Third Tuesday of each month

8-9 program days + November graduation

APPLICATION TIMELINE
Applications Open: Monday, November 17, 2025

Applications Close: Friday, December 26, 2025

Acceptance Notifications: No later than Tuesday, January 6, 2026 (via email)

Participant Commitment Form Due: Friday, January 9, 2026

Formal Class Announcement: Week of January 12, 2026

Program Kick-Off: 2026 State of the Chamber Program (date forthcoming)
Personal Information
Full Name (Dr./Mr./Ms./Mrs.)*
Preferred Name*
Employer*
Job Title*
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Length of Residence in Bolivar County*
Age*
Education
Education (schools, dates, degrees, certifications)*
List schools attended, dates, degrees, and/or certifications.
Employment
Current Employer*
Position*
Type of Organization*
Employed Since (month/year)*
Major Responsibilities*
Professional Affiliations*
List any professional associations, boards, or memberships.
Previous Employment*
List previous key positions and organizations (if applicable).
Community Activities
Civic, Volunteer, or Community Involvement*
Awards/Recognition*
General Questions
Why do you want to participate in L.E.A.D. Bolivar?*
What strengths will you bring to the cohort?*
How will you use your leadership skills to impact Bolivar County?*
Employer Commitment
EMPLOYER’S COMMITMENT
I support the applicant’s participation and understand the time commitment. If accepted, I understand the program fee is $500.
Employer Name & Title*
Employer Email*
example@example.com
Do you approve this applicant's participation and understand the $500 program fee if they are accepted?*

Yes, I approve.No, I do not approve.
APPLICANT’S COMMITMENT
I certify that the information provided is accurate. I agree to participate fully in L.E.A.D. Bolivar and understand that if I am accepted, the Participant Commitment Form must be submitted by January 9, 2026, to secure my seat.
I have read and agree to the Applicant's Commitment Statement above.
Date*

MonthDayYear
Date
Should be Empty:

ABOUT THE PROGRAM

Personal Information

Education

Employment

Community Activities

General Questions

Employer Commitment