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 Middle Last Home Address* Address Lane 1 City ZIP / Postal Code State*AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificHome PhoneCell Phone*Personal Email* Social Media Profiles*Please put the links to your Linkedin, Facebook and any others you wish to share separating them with a commaHow did you learn about Leadership SouthCoast?*Employment and EducationEmployer* Position / Title ** Employer Address* Address Lane 1 City ZIP / Postal Code State*AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWork Email* Work Phone*Type of Organization **PublicPrivateNon-ProfitPlease select oneUpload ResumeMax. file size: 2 MB.PDF onlyCommunity InvolvementPlease 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*DiversityBriefly 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 QuestionsEssay #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 wordsEssay #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 wordsEssay #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 wordsReferencesFirst Reference*Please type the name, title, email address, phone number and organization of your first referenceSecond Reference*Please type the name, title, email address, phone number and organization of your second referenceThird Reference*Please type the name, title, email address, phone number and organization of your third referenceFinancial CommitmentsEmployer's or Sponsor's Tuition Contribution* Please enter the amount your Employer or Sponsor will contribute towards the $3,750 tuition costParticipant's Tuition Contribution* If the amount above is less than $3,750 please enter the amount you plan to contributeTuition Assistance Request (If you select Yes, please complete the Tuition Assistance Form after submitting this application)*Select BelowYesNoPlease select one Note to Applicants: You are responsible to ensure that your employer/sponsor completes the Employer/Sponsor Signature Form on this page.