Ignite Community Leadership - Class of 2025

Participant Application
Applications Accepted: September 3 - November 1, 2024
Participants Notified: November 15, 2024
Class Meets:
1st & 3rd Wednesdays
8:30am - 1:00pm
January 15 - May 21, 2025
Attendance in all sessions is expected.
Class size is limited.

PERSONAL

First Name *

Last Name *

Preferred Name (if different)

Home Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Home/Cell Phone Number *

EMPLOYMENT

Employer *

Occupation/Title *

Work Email *

Work Phone *

Length of time at this employer *

Immediate Supervisor *

Supervisor Email *

Work Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

EDUCATION

Where did you attend high school? *

What do you consider your highest responsibility, skill or career achievement so far? *

COMMUNITY INVOLVEMENT

Why would you like to participate in the Ignite Community Leadership program? *

Tell us about your current community involvement i.e. volunteer work, civic clubs, professional associates, religious or social groups, athletic or other organizations you are involved with or a member of. *

In what type of community/volunteer activities would you like to become involved with in the future? *

ACKNOWLEDGEMENTS

If selected, who will be responsible for your tuition? *

Employer Self I'm interested in a scholarship

Tuition for the Ignite Community Leadership program is $1,500 (one registration per year included with Visionary, Stakeholder, and Leader level membership). Chamber Members receive a $500 discount. Limit 1 participant per organization per year.

If selected, I plan to attend 100% of the classes: WEDNESDAYS from 8:30am - 1:00pm on January 15 & 29, February 5 & 19, March 5 & 19, April 2 & 16, May 7 & 21. Graduation May 21. Snow Date: April 30 *

YES NO UNSURE

Dietary Restrictions

Other Accommodations Needed

Additional Comments

SIGNATURE

Attendance at all sessions must be a top priority. I understand the purpose of the Fergus Falls Chamber's "Ignite Community Leadership" program and if I am selected, I will devote the time and resources necessary to complete the program. I understand these commitments and agree to be bound by them by signing below.

For electronic signature, type full name *

EMPLOYER ACKNOWLEDGEMENT

A copy of this online application will be sent to your employer for approval.

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Ignite Community Leadership - Class of 2025

Fergus Falls Area Chamber of Commerce