This application is also available for download on ... Please return this application with your resume and a letter of r
The following biographical information is requested from all applicants. Please list the information as you would like it to appear in future materials. This application is also available for download on KingmanChamber.com.
EMPLOYMENT SECTION Applicant Full Name
Nickname
Title Organization
Name
How long have
you been employed there? Address City
State
Telephone
Fax
Zip E-mail
PERSONAL SECTION Home Address City
State
Telephone
Fax
Zip Cell
How long have
you lived in the Kingman Area? Education (begin with highest level completed) School
Dates
Degree
Recommended by
ORGANIZATIONS & ACTIVITIES SECTION List in order of importance to you, any civic, community, political, professional, religious, or other organization in which you are currently or have recently been involved. Organization
Membership Dates
Why are you interested in this program?
Position Held
What contributions do you feel you could make to the Leadership Kingman program?
Tell us about your most important contribution to the community.
In your opinion, what are the most pressing problems facing the Kingman Area today?
What specific skills/knowledge do you hope to gain as a participant?
Explain your greatest career achievement to date.
Do you hold a leadership role within one of the organizations listed on the front of this application? If so, describe how you demonstrate leadership.
Provide any other information you feel is relevant and would be helpful in evaluating your application. This program will require your attendance at all 10 classes and the graduation ceremony and participation in a community project chosen by the class. By signing this application, you indicate that you are fully aware of the time commitment that will be required as a participant in the Leadership Kingman program and will abide by those requirements and fully participate in the program to the best of your abilities. Tuition is nonrefundable after January 9, 2016. Payment arrangements and scholarships are available. Please contact the Chamber for more information. Please return this application with your resume and a letter of recommendation from your supervisor. If not currently employed, a letter of recommendation from someone who can attest to your potential as a leader.
