Leadership Raleigh
Confidential Application for Appointment

*Note: Only one applicant from each company will be accepted.*

Instructions
Please complete each section fully. Application must be approved by both applicant and employer/sponsor and returned no later than June 30, 2010. A personal photo will be taken at the August Orientation/Social.

Selection Criteria
A committee of graduates of the program reviews all applications and selects 50 individuals who represent a broad cross section of the community. Applications must show either potential for or demonstrated leadership abilities, community interest and involvement, and the desire to assume expanded leadership responsibility. DEADLINE for applications is June 30, 2010. Only one candidate per company will be selected to participate each year. SELECTION IS BASED UPON THE QUALITY AND DEPTH OF THE ANSWERS PROVIDED ON THE APPLICATION. PLEASE BE THOROUGH WITH YOUR RESPOSNES.

The LEADERSHIP RALEIGH Selection Committee, based upon the information supplied on this application, will choose participants. The selection committee will screen all completed applications and may request interviews from a portion of the applicants. The Committee will be seeking representation from a cross-section of the community. These leaders and potential leaders will be active in business, education, the arts, religion, government, community-based organizations, ethnic and minority groups and will reflect the diversity of the community. Participants will be notified of acceptance in mid-July. No tuition is due before acceptance.

Commitment Criteria
Applicants must have the full support of the organization or corporation they represent. To graduate from Leadership Raleigh:
1) Attendance at the fall retreat, spring report session and 6 of 8 monthly sessions is mandatory.
2) Absentees will be dropped from the program after two monthly sessions are missed.

Tuition
Upon acceptance into the LEADERSHIP RALEIGH program, a tuition check for $1,900 should be made out to the Greater Raleigh Chamber of Commerce and returned as soon as possible. The tuition covers the cost for the fall retreat, spring report session and 8 one-day sessions (including lunch and snacks), transportation for each session, program materials, staff time, orientation, graduation and membership dues for the first year in the alumni association. No refund of tuition will be made after August 20, 2011.

Scholarship Information
The Leadership Raleigh program has a strong commitment to capture the diversity of the community in its program participants and has made it a priority to encourage the participation of individuals displaying exemplary leadership in the non-profit community or as owners and operators of small or minority-owned businesses.

In achieving this goal, the John Freehafer Scholarship Fund seeks to ensure that financial circumstances are not a factor in these individual's decision to apply for participation in the Leadership Raleigh program. The scholarship monies are intended to ensure that this diversity is better achieved in each class of Leadership Raleigh.

Depending on the needs of each participant, scholarships will be awarded in the form of partial scholarships. The amount of partial scholarships will be determined by a combination of the number of applicants, their identified needs and available resources each year.


Calendar

Application Deadline June 30, 2010  
     
Accepted participants notified Mid-July 2010  
     
Orientation Mid-August 2010 Raleigh
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Fall Retreat September 24/25, 2010 Southern Pines
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Program October 12, 2010 Quality of Life
Sessions November 9, 2010 Law Enforcement/Public Safety
  December 14, 2010 Human Needs
  January 11, 2011 Local Economy
  February 8, 2011 Local/State Government
  March 8, 2011 Education
  April 12, 2011 Health Services
  May 3, 2011 Media
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Report Session May 20, 2011 Raleigh
Graduation Early June 2011 Raleigh

 


Financial Aid - See scholarship information above



An applicant's quality and depth of response will impact potential selection into the program.


I. Personal Data

Full Name:

Preferred Name:

Age:

Gender:

Race:

Place of Birth:

Home Address:

Business Address:

Home Phone:

Work Phone:

Fax:

Email:

Length of Residence in the Raleigh area:

If married, Spouse's Name:

Number of Children:

Names and Ages:

Hobbies:


II. Education
(Begin with college(s), advanced degrees, and/or specialized training.)

School Name and Location:

Degree / Major:

Attended School From:

Attended School To:

School Name and Location:

Degree / Major:

Attended School From:

Attended School To:

Special Awards for Academic Performance:

Extracurricular Activities: (Leadership positions held, special honors and awards received during school years.)

 


III. Employment

Present Employer:

Service Date:

Type of Organization:

Title or Responsibility:

A. Briefly describe your responsibilities in your employment:

B. List previous employment in reverse chronological order: (Include active military duty.)

Employer:

Title/Responsibility:

Employed From:

Employed To:

 

Employer:

Title/Responsibility:

Employed From:

Employed To:

 

C. What do you consider your highest career achievement to date?

 

D. Business/Professional Affiliations (if any): (Not including civic organizations, public office, or political activities)

Name of Group:

Position Held or Assignments:

Affiliation Start Date:

Affiliation End Date:

 

Name of Group:

Position Held or Assignments:

Affiliation Start Date:

Affiliation End Date:

 

Name of Group:

Position Held or Assignments:

Affiliation Start Date:

Affiliation End Date:

 


IV. Community Involvement
(Include community, civic, religious, political, government, social, athletic, or other activities. Do not include business or professional activities. Indicate major role in the organization at this time.)

1a.Organization:

Assignment/Position:

Describe responsibilities:

 

1b.Organization:

Assignment/Position:

Describe responsibilities:

 

2.How do you decide what activities to be involved in?

3. What do you consider your most important accomplishment in one of the listed organizations?

4. Have you been as active in community, civic, professional, and other activities as you would like to be? Why or why not?

5. If you have previously not had the time or interest to become actively involved, what conditions have changed that now enable you to seek involvement in the community?

 


V. General Information
(One of the goals of Leadership Raleigh is to build a network of community leaders who can enhance their problem-solving and other leadership abilities through shared perspectives and working together.)

1. What are the three most significant challenges facing the Greater Raleigh/Wake County area today?

2. What are the three most notable opportunities Greater Raleigh/Wake County area has to offer?

3. What do you think needs to be done to develop one of these opportunities or solve one of the challenges?

4. What specific skills/knowledge do you hope to gain from your participation in Leadership Raleigh?

5. How do you plan to apply the knowledge gained in Leadership Raleigh?

 


Candidate Program Agreement
I have reviewed the program calendar and agree to meet the requirements of attendance during the program.

Full Name:


Supervisor Contact
(supervisor will be contacted for verification)

Full Name:

Phone:

 

 


Questions?
Call 664.7082 or email Greg McNamara.

 

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