Online Application

CONFIDENTIAL APPLICATION

To participate in Leadership Lenoir, a major time commitment from February through June is required. Classroom training and tours will require approximately six working days over a five-month period. Tuition per participant in Leadership Lenoir is $350.00.

Application deadline is February 20, 2008
 

Name
Sex	Male Female
Home Address
Home or Cell Phone
Personal E-mail
How many years have you lived/worked in Lenoir County?

EMPLOYMENT INFORMATION

Employer
Date of Hire
Position/Title
Address
Address (cont.)
City
State
Zip
Work Phone
Fax
E-mail

Are you a registered voter?

YES
NO

Which one of the following categories best describes your present area of leadership activity or interest: (Check one)

Social Service Government Media Religion Business & Idustry Law Education Medical Arts Other (specify)

Other (specify)

ORGANIZATIONS & ACTIVITIES
Please list up to five community, civic, professional, business, religious, social, athletic
and other organizations of which you have been an active member.

Organization 1.

Date of Membership:

Position Held:

Organization 2.

Date of Membership:

Position Held:

Organization 3.

Date of Membership:

Position Held:

Organization 4.

Date of Membership:

Position Held:

Organization 5.

Date of Membership

Position Held:

In your opinion, what are the two most important issues facing Lenoir county today.
Explain why and suggest recommendations for approaching and resolving these issues.

List any accomplishments, honors or recognitions:

What do you hope to gain from Leadership Lenoir?