Leadership Lawrence County!

Class of 2018-2019 Application

Ready to Make A Difference In Your Community & Join a Network of Leaders?

Leadership Lawrence County! provides an opportunity for leaders and individuals committed to making a different in Lawrence County and its surrounding region to:

Become acquainted with processes, programs,

and challenges that currently exist in the

community.

Gain an understanding of the public and

private operations within Lawrence County

and the state of Pennsylvania.

Gain a deeper understanding of the issues

endemic to the region by observing and

hearing the views of others.

Programs are engineered for class participation

and dialogue and cover topics as: Economic

Development, Education, Environment, Health

Care, Local Government, Social Services, State

Government, and Quality of Life.

Leadership Lawrence County Sponsor:

Lawrence County Regional

Chamber of Commerce

Leadership Lawrence County! Class of 2018-2019

TENTATIVE

SCHEDULE

October 25-26, 2018

November 8, 2018

December 6, 2018

January 17, 2019

February 7, 2019

February 28, 2019

March 21, 2019

April 11, 2019

May 2, 2019

May 23, 2019

Tuition & Program Commitment

Application & Selection Process

Tuition for the 2018-2019

Program will be $1,000.00 and

may be paid by the individual

or the sponsoring institution.

A limited number of partial

scholarships will be available

to individuals who might

otherwise be unable to

participate.

Participants will be selected from a

diverse mix of the local population -

business, government, education,

religious, and civic groups, the arts,

and organized labor. Applications

are encouraged from all segments of

the community.

Candidates will be chosen by a

Selection Committee. Each

candidate will be evaluated by

criteria that take diversity,

community involvement, and

demonstrated potential leadership

capabilities into consideration.

All applications will be handled in

the strictest confidence.

Participants for the class of 2018-

2019 will be selected from those

who have submitted a completed

Application form by Friday,

September 21, 2018. To assist the

Selection Committee, we request

the forms be typed or printed

legibly.

ParticipationIn order to accomplish the

objectives of the program, the

full participation of each class

member is necessary.

Participation includes:

Orientation (Two-Day Retreat) - Thursday, October

25 beginning at 9:00 a.m.

through Friday, October 26

ending at 4:00 p.m. (Full

attendance is mandatory!)

Participation involves the

equivalent of one full day per

month, with most meetings on

Thursdays.

Completing your Leadership Lawrence County! Application Read Application and Selection Process sections thoroughly.

Include 3 references and the most recent copy of your resume.

Do not send checks to cover tuition now; accepted participants will be billed their tuition.

Applications must be post-marked by September 21, 2018.

All applicants will be notified of their status by September 28, 2018.

Incomplete applications will not be accepted. Mail complete form to: Lawrence County Regional Chamber, 325 East Washington St., New Castle, PA 16101 or email to: info@lawrencecountychamber.org

Leadership Lawrence County! Class of 2018-19 Application

PERSONAL First Name: ____________________ Middle Initial: _____ Last Name: ______________________ Name (or nickname) as it should appear on your name badge: ______________________________ Home Address: __________________________________________________________ City: _________________________ State: _________ Zip: ____________________ Mobile Number: (_______)________________________ Personal e-mail address: ___________________________________________________________ Years living in the area: ____________ Years living in Lawrence County: _____________ Have you ever participated in another community leadership program? Y/N_____________ If so, when? _______________________________ Where? ________________________________ How did you learn about Leadership Lawrence County? _______________________________________________________________________________ EMPLOYMENT Present Employer: ________________________________________________________________ Type of Business: _________________________________________________________________ Current Title: ________________________________ Number of years at this organization: _______ Work Address: ____________________________________________________________________ City: _______________________________ State: __________ Zip Code: _____________________ Work Phone: (_______)________________________ Work E-mail Address: _______________________________________________________________ Employer website: _________________________________________________________________ Briefly Describe Your Responsibilities: __________________________________________________ ________________________________________________________________________________

List your last three previous employers, including military duty:

Employer: Title/Responsibility:

Period of Service:

What professional awards/recognition have you received? ________________________________________________________________________________ What do you consider your most significant achievement? ________________________________________________________________________________ EDUCATION (Start with the highest-level attained and work back through high school).

Institution Dates or Date of Graduation

Degree Area(s) of Study

COMMUNITY INVOLVEMENT List in order of importance to you, activities in which you have been involved over the past five years, either civic, professional, athletic, social, religious, community or cultural:

Organization Responsibility Dates

Explain the reason for your commitment to your major volunteer role. __________________________________________________________________________________________________ __________________________________________________________________________________________________ How many hours do you commit to volunteering monthly? _______________________________

If you have not been involved in the community in the past few years, what has changed to make you seek involvement at this time? _______________________________________________________________________________________ __________________________________________________________________________________________________ What community activities do you see yourself involved with in the future? __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ One of the goals of Leadership Lawrence County is to build a network of community leaders who can enhance their problem-solving skills and other leadership abilities through shared perspectives and working together. What do you feel are the three most challenging issues facing Lawrence County today? __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ What contribution(s) can you make to address these issues? __________________________________________________________________________________________________ __________________________________________________________________________________________________ What do you believe are Lawrence County’s two most valuable assets? __________________________________________________________________________________________________ What do you expect to gain from participation in the Leadership Lawrence County program? _________________________________________________________________________________________________ _________________________________________________________________________________________________ What, if anything, hinders you from getting involved in the community or community groups? _________________________________________________________________________________________________ _________________________________________________________________________________________________

PROGRAM INFORMATION Tuition Tuition is $1,000 per participant. The tuition includes a two-day retreat, sessions, guest lecturers, materials, meals, transportation and other program essentials. Company sponsors are encouraged to pay the tuition of their participants. A limited number of partial scholarships are available. If accepted to the program, is tuition assistance needed: Yes No If yes, please list the amount $X of assistance needed*: ________________ *On a separate piece of paper, please provide a statement of need and be sure to submit with completed application. Commitment Candidate: I understand the goals of Leadership Lawrence County and my commitment to the program. If selected, I will attend all sessions/functions and devote the time necessary to be a contribution member of Leadership Lawrence County. Further, I understand that lack of attendance may cause removal from the program. Candidate Signature: ___________________________________________________________ Financial Sponsor: I agree to pay $1,000 tuition fee for the above applicant, if accepted. I understand tuition is non-refundable. Signature of Financial Sponsor: ______________________________________________________________________ Print Name, Title, Organization: ______________________________________________________________________ Employer: I agree to allow my employee, if accepted, to devote the time necessary to be an active member of the Leadership Lawrence County program. Employer Signature: _____________________________________________________________________________ Print Name, Title, Organization: ____________________________________________________________________ Please send completed application, three references and the most recent copy of your resume to:

Lawrence County Regional Chamber c/o Leadership Lawrence County 325 East Washington St. New Castle, PA 16101 Completed Applications must be received by Friday, September 21, 2018.