Contact Information

First name

Last name

Name as you want it to appear on your name tag

Phone

Home Address

Tell us a little about yourself and your background.

Current Employment

Present Employer

Position

Work Address

General

What do you hope to gain from your Leadership Mitchell County experience?

What does community engagement look like to you?

References

Reference 1

Title

Phone

Reference 2

Title

Phone

Commitment to Session Dates & Program Qualifications

Session dates & programs are listed HERE. Please confirm that you understand expectations and are available to commit to all of these dates. If you are unable to make it to all the sessions we ask that you consider applying next year.

I understand I am expected to attend all sessions

Signature

2nd Year Commitment

As a graduating class member of LMC- 2nd year participation requirements include:

Co-facilitating a minimum of one class session alongside LMC board members during the 2027-2028 class
Participating in a planning workshop held in July of 2027 to prepare for next year's program
Participating with your fellow class members as hosts for the evening meal during the September 2027 class session located at Ringneck Ranch

I agree to the 2nd year commitments

Tuition

Tuition for the class is $300. If accepted, who will be paying your tuition?

Choose an Option

If you are an employer-sponsored applicant please download the Authorization to Participate form. This form is required before acceptance into the program can be granted.

Contact Information

Current Employment

General

References

Commitment to Session Dates & Program Qualifications

2nd Year Commitment

Tuition

APPLY