Thriving Henry Leaders℠ Program Application

Thriving Henry Leaders℠ Program Application

Hosted by the Henry County Chamber of Commerce with support from Kaiser Permanente
Thank you for your interest in the 2026 Thriving Henry Leaders℠ program. This program is a practical toolkit designed to provide business leaders with the strategies and support needed to navigate the unique challenges of leadership. We believe that a leader's well-being is the foundational asset of their business and a cornerstone of our community's economic health. This program aims to reduce stigma, provide education, and create a confidential, peer-support community to discuss the specific journey of a business leader.
Please complete the application below to be considered for the 2026 cohort.
Section 1: Applicant Information
Full Name:

First NameLast Name
Preferred Name (for materials):
Title:
Business/Organization Name:
Email Address:
example@example.com
Phone Number:
Number of Employees in Your Organization:

1 (Solopreneur)2-1011-5051-100100-499500+

Section 2: Leadership & Program Interest
Briefly describe your leadership role and primary responsibilities. This program is designed for those navigating the unique stressors of running an organization.
Why are you interested in participating in the Thriving Henry Leaders℠ program?
The program's welcome message states, "Your well-being is not just a personal matter; it is the foundational asset of your business...." What does this statement mean to you in the context of your own leadership?

The program is divided into six modules, including:

Understanding Stress & Building ResilienceSupporting Team Members with Mental Health ChallengesBuilding Team Psychological SafetyCreating Healthy Communication & Feedback FrameworksManaging Productive Conflict
Which of these areas represents the most significant challenge or opportunity for you as a leader right now, and why?
A key component of this program is creating a confidential, peer-support community. What do you hope to contribute to, and gain from, a group of your peers focused on these topics?
Section 3: Commitment & Acknowledgement
By signing below, I acknowledge and agree to the following:
- Participation: I understand this is a multi-module program and commit to attending all sessions (barring emergencies) to ensure a consistent and trusting cohort environment.
- Confidentiality: I agree to maintain strict confidentiality. Everything shared by my peers within the program sessions will stay within the program. This is essential for creating the psychological safety needed for honest discussion.
- Engagement: I commit to engaging with the guide, sharing with my peers, and using this opportunity to foster a culture of well-being within my own organization.
Signature:

Clear
Date:

MonthDayYear
Date
Thank you for your application. A member of the Chamber team will be in touch regarding your application status.
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