Clone of LEADERSHIP LINCOLN REGISTRATION FORM

LEADERSHIP LINCOLN APPLICATION FORM

PREPARE. MOTIVATE. ENGAGE.
All applications will be handled in the strictest confidence. Please be brief in your responses. Finalists will be selected and interviewed based on application material submitted. All interviews will be conducted by a selection committee.
Applicant Details:
Full Name

First NameLast Name
Employer
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number
Format: (000) 000-0000.
E-mail
example@example.com
In what areas of community life do you see yourself being active in the next 10 years?
What would you consider your highest responsibility, skill or career achievement so far?
Please describe your current civic activities, including memberships, volunteer activities and any leadership positions already held. (Attach additional pages if necessary).
What are your areas of particular interest for leadership involvement? (e.g., education, human services, government, religion)
What do you hope to gain, and how do you expect to utilize your Leadership Lincoln experience?
Number of years in Placer County?
Number of service years with current employer?
Please list 3 professional references (name, address, phone number, email & relation)
Please check review the below items for consideration of your application. By checking the "I agree" box you are able to committ to the below 5 items.

1.      I am able to attend at least 7 full-day sessions of the 9 listed below from 7:45am-5:00. (Lunch is served)

2.      I will attend a minimum of three city, school board, county or Chamber meetings/events.

3.      I will participate as a team member in a class project as a requirement of the program.

4.      I will commit no less than 8 hours a month for the class project or as needed.

5.      I am able to attend the graduation breakfast on May 26, 2027 from 7:30- 9:00 a.m.

(Missing any portion of a session counts as a missed session)
Sept 17 - Oct 15 - Nov 19 - Dec 10 - Jan 21 - Feb 18 - Mar 18 - Apr 15 - May 20
Tuition: The price for members is: $495 and non-members $595. Class participants are expected to pay at least $50.00 (payable at
the time of submission of this application).

Tuition is non-refundable and must be paid in full prior to the first class.
By signing below, you agree to the following terms: (1) Participation in the class leadership project is a requirement and must be met in addition to the classroom requirements once monthly. (2) You must not miss more than 2 sessions to be eligible to graduate from the program and receive your leadership certificate.

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2026 - 2027 Leadership Lincoln (Paid in Full) - Member Rate

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2026 - 2027 Leadership Lincoln (Paid in Full) - Non-Member Rate

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2026 - 2027 Deposit

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LEADERSHIP LINCOLN APPLICATION FORM

All applications will be handled in the strictest confidence. Please be brief in your responses. Finalists will be selected and interviewed based on application material submitted. All interviews will be conducted by a selection committee.

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