Name as preferred on badge______________________________
Employer_____________________________________________
Years with
employer ___________________________________
Position/Occupation___________________________________
Work
phone__________________________________________
Work
Address________________________________________
Email_______________________________________________
City and Zip__________________________________________
Fax
________________________________________________
Home Address________________________________________
Home
phone__________________________________________
City and Zip__________________________________________
Cell
________________________________________________
Please complete the following questions. Feel free to use additional
attachments if necessary.
1.) Why are you interested in this program?
2.) Have you been involved with the City or community-based activities?
What are they?
3.) What do you hope to obtain from this program?
4.) What professional organizations do you belong to?
5.) What service clubs/organizations are you involved with?
6.) What particular area(s) of the program is most appealing to you and
why?
Please note the following:
1.) Tuition is $400 and is non-refundable. This cost
covers meals, materials, speaker costs, and graduation ceremony. Plus special
project cost sharing (not to exceed $50/person).
2.) Applicants for Leadership Arvada, if employed, must have the support
and commitment of their employer. The employer must authorize participation in
the program.
__________________________________ __________________
(Employer's Signature) (Date)
3.) If selected to participate in Leadership Arvada, you must commit to
attendance for the full time allocated for that day's presentation(s).
4.) No more than two excused absences are permitted to participate in
graduation.
5.) Extra time will be required for your class project which will be
scheduled outside of Leadership Arvada class time. You and your classmates will
identify a project and determine related costs (if any).
6.) No substitutions are permitted for attendees.
7.) Employers will be invited to participate in the graduation
ceremony. Additional guests may result in additional costs to the
participant.
8.) Because of logistics and program design, there will be a limited
number of applications accepted. The selection committee will include
representatives of the Arvada Chamber of Commerce, Arvada Economic Development
Association (AEDA), and City of Arvada.
If selected to participate in Leadership Arvada, I agree to all the terms
and conditions of the program.
_________________________________
__________________
(Applicant Signature)
(Date)
Leadership Arvada is brought to you buy the Arvada Chamber
of Commerce and Arvada Economic Development
Association.
