Leadership Wilson

Apply Online – Leadership Wilson Online Application

Apply Online – Leadership Wilson Online Application

Fill out our form below to apply online for Leadership Wilson.

Leadership Wilson Online Application
Contact Information
First Name *
Last Name *
Middle Name
Nick Name
Preferred Name
Home Address (Street) *
Home Address (Box / Suite / Etc.)
Home Address (City) *
Home Address (State) *
Home Address (Zipcode) *
Email Address *
Phone Number *
Employer Information
Employer *
Employer's Address (Street)
Employer's Address (Box / Suite / Etc.)
Employer's Address (City)
Employer's Address (State)
Employer's Address (Zipcode)
Briefly describe your responsibilities. *
Commitment
How long have you lived in Wilson County? *
Have you been as active in community, civic, professional, and other activities as you would like? *
Yes
No
What activities are you currently involved in? *
What have been the major barriers to you getting more involved, and what has now changed to allow you to seek involvement? *
Education
Please outline your academic background and training.
High School *
College
Graduate Level
Special awards, honors, or prizes for academic performance
Extracurricular activities and special honors awarded for leadership activities
Participation
In order to accomplish our objectives, the full participation of each individual selected is necessary. Attendance is mandatory at the two-day retreat and eight monthly class sessions.
Will you be able to fulfill this commitment? *
Yes
No
Do you have the support of your employer for the time required to participate in Leadership Wilson? *
Yes
No
Why should you be selected to participate? *
What do you hope to gain, and how do you expect to utilize your Leadership Wilson experience? *
Community Analysis
Please identify a particular challenge, issue, or problem you feel is critical to the Wilson County area. Explain your concern and possible involvement in the solution of this issue *
Submission
If accepted to the program, tuition must be paid prior to the program start.
To complete you submission, please sign the application by typing your full name, including middle initial.
Signature *
Please answer the security question below to verify that you are a real person.
What COLORS are in the United States of America Flag?
Answer


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