Executive Management Program Application 2027

Begin with high school; include college(s), advanced degrees and/or specialized training.

List previous employment in reverse chronological order (include active military duty):

Industry/Community Involvement
List business/professional affiliations; community, civic, religious, social, political/governmental, athletic or other activities:
Organizations
Dates
General Information
What do you hope to learn through participation in the Executive Management Program?
What do you feel are your greatest strength's as a current leader in your organization?
What are 1 or 2 of your weaknesses as a current leader in your organization that you would like to address and improve upon?
Tuition
If accepted into the Executive Management Program, you or your employer will be billed for the tuition fee ($4,500) which covers all programs, costs, meals, lodging, etc.
Will your employer pay the tuition fee?
Commitment
Please be sure you can attend each of the sessions before signing this commitment.
I understand the purpose of the Executive Management Program and if I am selected I will devote the time and energy necessary to complete the program. Even though emergencies do arise, any participant missing more than one session, for whatever reason, may be asked to withdraw from the program and no portion of the tuition shall be refunded. I understand the above commitments and agree to be bound by them in signing this application.
Applicant Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
APPLICATION DEADLINE: December 1, 2026
Questions should be directed to: Jeff Roach, 608-221-3821, jeff.roach@agcwi.org
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Executive Management Program