CANDIDATE APPLICATION-2026/2027

Application Instructions:

Please complete the application in full. Required fields are marked with an asterisk (*).
SECTION 1: PERSONAL INFORMATION
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com

SECTION 3: EDUCATION & BACKGROUND
High School Attended:
College Attended:
Degree(s) earned:
Professional Certifications or Licenses:
SECTION 4: LEADERSHIP & COMMUNITY INVOLVEMENT
List community, civic, professional, or volunteer activities in which you are currently involved: (Include organization name and role.)
SECTION 5: PROGRAM INTEREST
Why are you interested in participating in the LCC Program?*
What do you hope to gain from this experience?*
What strengths or perspectives would you bring to the class?*

SECTION 6: COMMITMENT & EXPECTATIONS
The program requires:
- Regular attendance at scheduled sessions
- Participation in group discussions and activities
- Engagement in a community-based project
- Collaboration with fellow class members
I understand the attendance and participation requirements and commit to full engagement in the program.
SECTION 7: TUITION RESPONSIBILITY
ParticipantEmployerSponsor
Employer or Sponsor Organization Name:*
Contact Person:

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
AGREEMENT & SIGNATURE

By submitting this application, I certify that the information provided is accurate and complete to the best of my knowledge.
Signature*
Should be Empty:

CANDIDATE APPLICATION