LEAD SouthCoast Application

"*" indicates required fields

Important Notice: Due to the length of our application form, we recommend the following steps to ensure a smooth application process:

Review the Form: Please take the time to review all the questions on the form.
Prepare Your Answers: Compose your answers in a Word document or another text editor.
Submit in One Session: Once all your answers are ready, copy and paste them into the form and submit in one session.

Note: Several of our essay questions require an answer of at least 250 words.

Thank you for your understanding and cooperation.

Name*

First Last

Home Address*

Address Lane 1 City ZIP / Postal Code

State*

Home Phone

Cell Phone*

Personal Email*

Social Media Profiles*

Please put the links to your Facebook, Instagram, or any others you wish to share, separating them with a comma

LinkedIn URL*

Please provide your LinkedIn URL.

How did you learn about Leadership SouthCoast?*

Employment and Education

Employer*

Your Position/Title **

What is your position there?

Employer Address*

Address Lane 1 City ZIP / Postal Code

State*

Your Work Email*

Your Work Phone*

Your Supervisor*

Your Supervisor's Position/Title*

Your Supervisor's Phone Number*

Your Supervisor's Email

Type of Organization **

Please select one

Upload Resume

Max. file size: 10 MB.

PDF only

Community Involvement

Please describe your community involvement.*

Do you currently serve on a nonprofit or public board? If so, please note the organization name, and the length of time you have served*

Diversity

Briefly explain how diversity has played a role in your life and contributed to either the community leader you are today or the community leader you wish to become.*

Why are you interested in participating in Leadership SouthCoast? What do you hope to gain and what qualities will you bring to the class?*

Essay Questions

Essay #1: Please describe a community leader (you do not have to name them) that you admire and believe is highly effective. What are the specific qualities that you believe make them a strong leader? How did they deal with adversity? What lessons about leadership can we learn from them?*

This field requires a minimum of 250 words. The form will not submit until you have at least 250 words in this field.

0 of minimum 250 words

Essay #2: Describe a time (personal or professional) when your leadership was challenged, and your course of action did not prove successful. How did you persevere?*

This field requires a minimum of 250 words. The form will not submit until you have at least 250 words in this field.

0 of minimum 250 words

Essay #3: Describe a situation where you worked with others from a different background than yours. Based on your experience, what advice would you give to someone who will be working with others from different backgrounds?*

This field requires a minimum of 250 words. The form will not submit until you have at least 250 words in this field.

0 of minimum 250 words

References

First Reference*

Please type the name, title, email address, phone number and organization of your first reference

Second Reference*

Please type the name, title, email address, phone number and organization of your second reference

Third Reference*

Please type the name, title, email address, phone number and organization of your third reference

Financial Commitments

Employer's or Sponsor's Tuition Contribution*

Please enter the amount your Employer or Sponsor will contribute towards the $4,000 tuition cost

Participant's Tuition Contribution*

If the amount above is less than $4,000 please enter the amount you plan to contribute

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Note to Applicants: You are responsible to ensure that your employer/sponsor completes the Employer/Sponsor Signature Form:

https://leadershipsouthcoast.org/programs/lead-southcoast/employer-sponsor-signatures/