Leadership Autauga Application Form

Leadership Class of 2026- 2027

Application
Helping Build Tomorrow’s Leaders, Today!

Leadership Autauga County is a nine (9) session course designed to build, enhance and mold the leadership skills within Autauga County, Alabama.
The Experience

Curriculum: The program consists of nine monthly, full-day sessions focused on the key pillars of our county’s infrastructure and economy.
Mandatory Retreat: The program begins with an essential 2-day, 1-night overnight orientation and retreat held in Auburn. August 20 - 21st This orientation is mandatory for all participants.
Timeline: Sessions typically begin in the late summer/early fall, conclude in the spring, and culminate in a formal graduation ceremony.
Commitment & Certification To ensure the integrity of the program and the growth of the cohort, attendance is vital. Participants are required to attend the orientation and a minimum of seven full-day sessions to receive their graduation certification.

Participation & Tuition

Eligibility: We welcome applicants aged 18 and older from all backgrounds, industries, and sectors who are committed to the growth of Autauga County.
Cohort Size: To maintain an impactful and collaborative environment, classes are limited to 15–20 participants.
Investment: Tuition is $550.00. This includes all program materials and retreat costs. (Note: An additional $100 fee applies for those requesting a single-occupancy room for the retreat.)
Payment Instructions Upon submission of your application, you will have 14 days to pay the program fee. If you are not selected for the current cohort, your tuition will be refunded in full. Payments can be made via the following methods:

In-Person: Visit the Prattville Area Chamber of Commerce, Monday through Friday, between 9:00 AM and 3:00 PM.

Mailed Check or money order: 131 North Court Street, Prattville, AL 36067

By Phone: Call the Chamber at 334-365-7316 to process your payment over the phone.

Our Mission

Identify & Cultivate: Recognizing individuals with the passion to lead Autauga County into the future.
Educate & Inform: Providing deep-dive access to the resources and challenges within our region.
Unify: Fostering a spirit of cooperation and networking across the county.
Equip: Developing informed citizens ready to serve on boards, in office, and within their organizations.
Name

PrefixFirst NameLast Name
Birth Date

MonthDayYear
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Food Allergies or Dietary Restrictions?
Emergency Contact

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Educational Background
College/School
Department/Field
Other Education
List of Honors and Awards for Academic Performance:
Occupation
Company
Department/Position
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Organizations & Activities
List community, professional, civic, religious and other organizations that you are or have been affiliated with and the offices you hold or have held:
Is there any other interesting item(s) that you would like the Selection Committee to know about yourself? If so, please explain:
PARTICIPATION IN LEADERSHIP AUTAUGA COUNTY
What do you hope to gain from your involvement in Leadership Autauga County?
In your judgment, what are the three most pressing problems facing the Autauga County area and can you suggest recommendations for solutions?
Will you be able to attend the Leadership Autauga County sessions as outlined?
Do you have full support of your employer for the time required to participate effectively in Leadership Autauga County? (By typing yes, you give us permission to call your employer and verify eligibility to participate in the full years class.)
Did anyone refer you to Leadership Autauga County?
MEMBERSHIP & FEES
Membership Type?

Other
Prefered Room type for retreat:
Additional notes about your schedule that we need to know?
Please verify that you are human
Date

MonthDayYear
Date
Signature
Should be Empty:

Leadership Class of 2026- 2027

Helping Build Tomorrow’s Leaders, Today!

Educational Background

Occupation

Organizations & Activities

PARTICIPATION IN LEADERSHIP AUTAUGA COUNTY

MEMBERSHIP & FEES