Leadership Application Form

AUSTIN AREA CHAMBER OF COMMERCE

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Signature of Applicant: *

Home Phone: *

Leadership Austin Application

Work Phone: *

Home Address: *

Complete and submit the application form below and upload your answers to the above questions.

City, State, Zip: *

Preferred Name:

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Upload Answers to Questions *

Signature and Title of Applicant's Sponsor (if appropriate): *

Address: *

Cell Phone:

References: List your supervisor and at least one other person who may be contacted by the selection committee. *

Company: *

Full Name: *

City, State, Zip: *

Date: *

Title: *

Email: *

2017-18 Leadership Austin Application Application Deadline: June 11, 2018

The selection committee will choose participants based on their responses to the following questions. Please answer them as completely as possible on a separate printed page and upload file(s) or mail to: Leadership Austin, 329 N. Main St., Suite 102, Austin, MN 55912)

State your professional and educational background or enclose a resume. Includes degrees awarded, fields of study, professional institutes, training programs, etc. List professional affiliations, community, religious, athletic and social organizations with which you have been or are currently involved.
Describe a professional or community leadership challenge you have undertaken.
If you have not participated in professional or community activities, explain what has changed that will allow you to be involved in the future.
What would you contribute to the LEADERSHIP AUSTIN class?
In what ways do you think LEADERSHIP AUSTIN can help you develop your leadership potential? What do you expect of the program? (Please submit approximately half a printed page.)
Identify and discuss an issue that you feel is critical to LEADERSHIP AUSTIN. (Please submit approximately half a printed page.)

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