LPC Application Form

Leadership Plant City Application Form
What is Leadership Plant City?

Since 1983, Leadership Plant City has been an innovative leadership training and community awareness program developed by the Greater Plant City Chamber of Commerce. The mission for Leadership Plant City is designed to identify and motivate current and future leaders of the Greater Plant City Community, and to develop their potential for leadership roles by introducing them to the elements that comprise our community, its potential, and its realities.

Sessions are planned to provide participants with an increased knowledge of the many functions of life in our community. Session formats will vary, but will include interesting field trips, panel discussions, knowledgeable speakers, and group interaction.

Who Participates in Leadership Plant City?

Nominations/applications for individuals who have a genuine interest in community leadership and who wish to increase their level of involvement in community leadership roles are sought from all segments of the community.

Nominated individuals are then encouraged to apply. Applicants must have the support and commitment of his/her business or organization, and must commit to 100% attendance at the ten (10) day-long sessions.

Selection Criteria
- Demonstrated ability to set and achieve personal & professional goals
- Demonstrated personal commitment to the Plant City community
- Commitment to be a responsible and engaged participant
In order to ensure a diverse group, only one representative from a business or organization may participate during the same year.

How It Works

Leadership Plant City is governed by the Plant City Chamber Board of Directors and is managed by the Leadership Committee. The Committee has the responsibility of establishing policy, selecting class participants and reviewing the program curriculum. The events are coordinated by Leadership Alumni and Chamber staff.

Tuition

Tuition is $1295.00 for Chamber members, and $1395.00 for non-members (includes a $100 discount on a new membership). This covers expenses such as class materials, transportation, retreats, and training. Once accepted into the program, tuition payment is due by August 4, 2026. Tuition is non-refundable. Please make checks payable to the Greater Plant City Chamber of Commerce, and mail to 2504 Walden Woods Drive, Plant City, FL 33566
Application Form 2026-2027

All information submitted in the application will be considered confidential and only used for the purpose of selecting participants in the Leadership Plant City program.
Applicant's Name

PrefixFirst NameLast Name
Applicant's Employer
Applicant's Job Title
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preffered Email
example@example.com
Phone Number
Format: (000) 000-0000.
Gender
Date of Birth

MonthDayYear
Date
Years at Current Job
Years in Plant City
More Information
Please write a brief autobiography in the space provided or attach a document to your application.
File Upload

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What do you expect to gain from your participation in Leadership Plant City?
What personal and professional qualities would you bring to the class?
Please identify and discuss a particular issue, opportunity, or problem you feel is crucial to the Plant City area. Include recommendations you may have for approaching and resolving these problems. (Please use space provided.)
Community Involvment (List organization, dates of involvment, position held, etc.)
College/School
Training/Certificates
References

List two people, other than your employer, who are knowledgeable about your leadership performance and potential, and who may be contacted by the Leadership Plant City Committee.
Name

First NameLast Name
Email
example@example.com
Name

First NameLast Name
Email
example@example.com
Other Contacts

Please provide contact information as listed below, and who also may be contacted by the Leadership Plant City Committee.
Spouse/Other

First NameLast Name
Email
example@example.com
Close Friend

First NameLast Name
Email
example@example.com
Colleague

First NameLast Name
Email
example@example.com
Attendance Policy, Requirements & Cell Phone Policy

To gain the maximum benefit from the program, class members are expected to attend all sessions and to conduct themselves in a professional manner. Participants who miss more than one scheduled session will not graduate from the program and will not receive a tuition refund. If you cannot commit this year, please consider applying for a future session. Please refer to the 2025-2026 session schedule attached.

Arriving early is “on time”. Tardy occurrences will be fined $20.00 for the first 5 minutes, and anything past 5 minutes is considered an absence.

During the year, each attendee is required to attend one of each of the following:

City Commission Meeting
Chamber Networking Lunch
Chamber Business After Hours Event
Chamber Member Orientation
Plant City Police Ride-a-long

Additionally, each class participant is required to perform four (4) volunteer hours at a Plant City Chamber-sponsored event.

There will be two (2) class projects during the year.

1. A project determined by the class participants and approved by the Leadership Committee that involves community

service. Specific projects will be presented to the class.

2. Creation of a video, skit, or other type of media presentation to be presented at the Leadership graduation ceremony.

** All class members must participate in both projects.**
Cell phone usage / texting is prohibited. Anyone using a cell phone during class hours will be levied a $20.00 fine. All fines will be collected at the end of the day, and donated to a charitable organization selected by the class at the end of the year.
If selected as a participant, I understand the purpose of the Leadership Plant City program and its attendance requirement. I understand if I fail to meet any of the program obligations, I may be asked to withdraw or may not graduate with my class. I realize the completion of this form does not guarantee my acceptance as a participant.
Employer’s Agreement: As the employer/supervisor of the above applicant for Leadership Plant City, I hereby agree to arrange the time necessary for his/her full participation in all scheduled classes and activities.
Please enclose your best "selfie" (be creative!) with your completed application.
File Upload

Cancelof
Application Deadline - May 31, 2026

Applicants will be notified of the application status no later than July 1, 2026

Non-refundable tuition due by August 4, 2026

Questions? Contact: Jerilyn Rumbarger, President & CEO (813) 754-3707
Liability Release form

DISCLOSURE: Leadership Plant City’s monthly programs typically involve a variety of different components and trips to different locations (for example, police department, a jail, one or more area hospitals, and one or more area schools) at which individual and group activities or tours will occur. Because of the activities involved and the locations visited, a risk exists and must be assumed by each participant that he or she may suffer physical or emotional injury. To assist Leadership Plant City in providing a safe experience, participants are asked to provide us with information regarding any limitations, conditions or disabilities you may have that could affect your safety or the safety of class situations.

RELEASE OF LIABILITY: I have read and understand the disclosure statement above. I understand that Leadership Plant City’s program may be physically or emotionally demanding. I recognize the inherent risks of injury or disability inherent in my participation in Leadership Plant City’s program and I assume the risk of injury that could result from any of the class activities.

I RELEASE LEADERSHIP PLANT CITY, PLANT CITY CHAMBER OF COMMERCE, ITS STAFF MEMBERS, OFFICERS, DIRECTORS, REPRESENTATIVES, AGENTS AND AFFILIATES FROM ALL LIABILITY FOR ANY INJURY (INCLUDING, BUT NOT LIMITED TO, PERMANENT AND FATAL INJURY) TO ME AND OR DAMAGES TO OR LOSS OF MY PROPERTY RESULTING FROM MY PARTICIPATION IN THE LEADERSHIP PLANT CITY PROGRAM, AND ACCEPT ALL RESPOSNIBILITY FOR MY PERSONAL SAFETY.
Signature
Date

MonthDayYear
Date
Should be Empty:

Leadership Plant City Application Form

Application Form 2026-2027

More Information

References

Other Contacts

Attendance Policy, Requirements & Cell Phone Policy

Please enclose your best "selfie" (be creative!) with your completed application.

Application Deadline - May 31, 2026

Applicants will be notified of the application status no later than July 1, 2026

Non-refundable tuition due by August 4, 2026

Liability Release form