Leadership La Crosse – Class of 2027 Application
Complete this application with your contact details, professional background, community involvement, goals, and commitment to full program engagement.
Page 1 – Applicant Information
Name
Email
*
example@example.com
How did you hear about Leadership La Crosse?
Please Select
Alumni
Employer
Chamber
Social Media
Website
Other
If referred by an alumnus, name and class year
Page 2 – Professional Information
Employer / Organization
*
Job Title
*
Years with Current Employer
Years in the La Crosse Area
Briefly describe your current role and responsibilities
Page 3 – Community Service & Engagement
Describe a community issue in the La Crosse area you care about and how you have been involved in addressing it
*
What leadership roles have you held in volunteer, civic, faith, or nonprofit organizations?
Page 4 – Professional Goals & Achievements
Describe a professional accomplishment you are most proud of and the leadership skills it required
*
What are your professional and leadership goals for the next 3–5 years?
*
How will participating in Leadership La Crosse help you reach those goals and benefit your organization?
*
Page 5 – Commitment to Full Engagement
Program Commitment
I understand that full attendance is expected and that missing more than 2 sessions may affect graduation.
*
I understand
Do you anticipate any conflicts with the program schedule?
*
Yes
No
Please explain any anticipated conflicts.
What unique perspective or experience would you bring to the cohort?
*
Page 6 – Employer Support & Signature
Employer Support
*
My employer supports my participation, including time away from work for program days.
Applicant E-Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Certification
*
I certify that the information provided is accurate and complete.
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