Class of 2025 Emerging Leaders Application

EMERGING LEADERS CLASS OF 2025 APPLICATION

Join a group of high potential women for a year-long course focused on measurable leadership development.

From sessions with real-life examples shared by regional thought leaders to active-learning based small group sessions,
you will graduate Emerging Leaders with the skills and tools to take your leadership to the next level.

Apply to be an Emerging Leader by August 30, 2024 by filling out the application below!

Please note that you can go between tabs, however you won't be able to click submit until all required fields are complete.
Program acceptance occurs on a rolling basis and an invoice will be sent to your billing contact upon acceptance.

Questions? Contact Carrie Taylor at carrie@centralexchange.org.
Your Full Name*

First Name (this will be the name on your graduation certificate)Last Name
Preferred First Name
Please let us know how you want to be called in class. Whether you prefer to go by your middle name, a shortened version of your first name, or a nickname, we want to know.
Company/Organization*
Current Job Title*
Work Email Address*
Personal Email Address*
Which email address do you prefer general communication about Emerging Leaders and Central Exchange? Because some emails will come from Constant Contact, if your company has high security for outside emails, we recommend choosing your personal email address.*

Work EmailPersonal Email
Work Phone
For numbers inside the US, please add a "1" as the country code.
Cell Phone*
For numbers inside the US, please add a "1" as the country code.
Company/Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Preferred Mailing Address*
Where would you prefer Emerging Leaders materials be mailed? Please note, we ask that this address can accept packages, as virtual cohorts will receive a box with class materials.

Billing Contact Full Name*
Who should receive the invoice? This is typically your accounting department unless the invoice is going to you directly.
Billing Contact Email*
Billing Contact Phone Number*
For numbers inside the US, please add a "1" as the country code.
Is the billing address the same as your company or personal address or is it a different address?*

My Company AddressMy Home AddressA Different Address
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Organization Type*
The corporate rate for virtual and in-person cohorts is $6,000 per participant. An invoice will be sent to the billing contact listed above upon acceptance to the program. If your company/organization is a Central Exchange Partner, a $500 discount will be applied to your invoice.

**Please note, payment is due no later than September 30, 2024.**
The Emerging Leaders Nonprofit Rate is based on your organization's prior fiscal year income. To find your income, refer to line 12 of the most current 990, line 9 of the 990EZ, or Assets line 16(b) of the 990-PF.

Nonprofit Rates:
- $1,500 (Prior fiscal year income: $500,000 - $999,999)
- $2,500 (Prior fiscal year income: $1,000,000 - $4,999,999)
- $3,500 (Prior fiscal year income: $5,000,000 - $9,999,999)
- $5,000 (Prior fiscal year income: $10,000,000+)
The rate for virtual and in-person cohorts is the same. An invoice will be sent to the billing contact listed above upon acceptance to the program.

Please note, we only accept up-to 4 students per cohort at the non-profit rate each year, and only 1 employee from each non-profit is allowed to enroll each year. We will notify you if we have reached the maximum amount of students or if someone else from your organization has already applied, then you will have the opportunity to still attend this year at the corporate rate or postpone your enrollment to next year.

**Payment is due no later than September 30, 2024.**
Select Your Non-Profit Rate*
Nonprofit Type*
ex. 501c3, 501c6, etc.