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Leadership Liberty Application

Leadership Liberty Application2025-02-03T21:16:12+00:00

 

Leadership Liberty Application

"*" indicates required fields

Your Personal Information

Your Name*
Your Email Address*
Employment*
Address*
Please upload a photo.
Max. file size: 36 MB.
If accepted into the program, I permit my photo to be taken on program days & used on the Liberty Area Chamber of Commerce website and in Leadership Liberty marketing materials.

Additional Information

How did you learn about Leadership Liberty?*
Education Information*
Please list your educational achievements in order of most recent (degrees, certificates, etc.).
Institution / Organization
Date Attained
Degree / Major / Certificate
 
Business / Professional Information*
What leadership experience do you have? Please list your top three business/professional involvements: government, civic, charitable, religious, social, or other.
Organization
Position Held
Describe Responsibilites
Years Involved
 
Please provide two letters of recommendation. One from your company’s leadership or your direct supervisor. The other letter should be from an individual (other than an employer or spouse). Contact information is required for both references.
Drop files here or
Accepted file types: pdf, doc, docx, Max. file size: 10 MB, Max. files: 2.

    Agreements

    Employers are in a position to recognize leadership potential. Therefore, applicants for Leadership Liberty must have their employer's full support and commitment because attending every session is mandatory to complete the program. The signature of the applicant’s manager or head of the organization is needed below. This applicant has my support for the time commitment required to actively participate in the Leadership Liberty program. I have reviewed the program dates and agree the employee will be able to attend and will have limited communication access during all sessions.
    Clear Signature
    If selected as a participant in the Liberty Leadership program, I am committed to attending and participating in all sessions sponsored by the program. I understand that contact with my office will be limited during sessions.
    Clear Signature

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