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Engaging Leaders Throughout North Carolina
Application Information


Application Information for Class XVI  (2008-09)
Read the instructions below carefully and review the entire form that follows before beginning.
You will not be able to save the form and return to it later; it must be completed in one sitting.

 
Program Schedule for Class XVI
 Each Session will be held on two full days (Thursday and Friday), with optional activities on Wednesday afternoon. (Exceptions:  the Orientation Session will be held from 2 pm Monday afternoon - Noon Wednesday, and the Annual Meeting will be held on a Friday).  The remaining Sessions will begin at 8 am on Thursday and conclude by 4 pm on Friday; note the Session locations as you make travel plans:
 
Orientation   October 6 - 8, 2008
  Boone
   
Government   November 5 - 7, 2008
  Raleigh
   
Economic Development   December 3 - 5, 2008
  Charlotte
   
Education   February4 - 6, 2009
  Greenville
   
Health & Human Services   March 4 - 6, 2009
  Hendersonville
   
Environment   April 1 - 3, 2009
 Morehead City
   
Annual Meeting
and Graduation		   May 14, 2009
  Greensboro

Attendance
 To graduate, participants are expected to attend all Sessions (attendance at the Orientation Session is mandatory; failure to attend Orientation in full results in automatic withdrawal from the program).  Absences at the five remaining Sessions are counted in segments – there are 25 segments during the program year (five Sessions with five segments each: morning and afternoon on both full days, plus the intervening class dinner).  If more than six segments are missed, the participant is automatically withdrawn from the program.  There are no “excused absences,” even for personal/family emergencies, work requirements, etc.  This is not punitive - the Board of Directors has simply determined that missing more than the number of segments outlined here results in an unrecoverable loss of both content and class interaction.  This is a firm policy - be sure to consider it carefully before applying.  Tuition is non-refundable.

   Selection Criteria
 The Selection Committee seeks to identify persons most likely to utilize their leadership abilities for the state’s long-term benefit.  Class size is typically around 50. Applicants not selected are encouraged to apply in subsequent years since space limitations will result in a number of highly qualified applicants not being selected for Class XVI.

The Selection Committee will seek diversity in areas including, but not limited to, profession, geography, career stage, ethnicity and gender. Successful candidates will be active in business, education, the arts, religion, government, community-based organizations, ethnic and minority groups, etc. – and will reflect the diversity of North Carolina’s communities.

 Tuition
 Tuition for the 2008-09 program year is $3,900 and is due upon notification that you have been accepted into the program (must be paid in full at least one month prior to the Orientation Session to avoid cancellation).  Most meals are included (breakfasts are typically continental), but participants are responsible for travel and lodging costs (out-of-town participants are encouraged to stay in the “base” hotel selected by Leadership North Carolina for each Session – this is required for the Orientation Session; a list of these hotels will be made available to those accepted into the program).

 Tuition Assistance
 Funds are available to offer a limited number of partial need-based scholarships to candidates who expect to bear some or all of program costs personally. Please email Brian Etheridge to request a 2008-09 Scholarship Application (note that scholarship applications should be submitted promptly after completing this online application and no later than June 30, 2008).  
 

 Applications are due by June 30, 2008.
Applications will be reviewed in July, and notification will begin in early August.
 
 
Confidential Application for Class XVI (2008-09)
 
Personal Data
Title

 		First Name

 		Middle Name
 Last Name
 Name Called
Home Street Address
City
 State
Zip
 County
Home-Phone
- - 		Gender
 Ethnic Origin/Race
 Birth Date
    

Email Address:   **Work email preferred if available**

How long have you lived in North Carolina (if split, indicate time periods):
If you have participated in any state, community or other leadership programs, please list up to three (indicate name of program and dates for each):

1.
2.
3.
 
Education
Begin with highest level (Doctoral, Masters, Bachelors, Associates). List High School if no post-secondary education:
Institution
1.
2.
3. 		Dates
1.
2.
3. 		Type of Degree/Diploma
1.
2.
3.
 
Employment
Present Employer

 Position
 Year Employed
Business Mailing Address (type exactly as it should appear in correspondence; include Division or Department, Box #, Room #, etc. if applicable)
Business Phone
- - 		Your employment category
Briefly describe your responsibilities:
What do you consider your highest career achievement to date?
Prior Employment (list most recent employer, your position/s there, and dates of employment)
 
Narrative
All six questions must be answered in order for your application to be considered complete.  Brief responses are welcomed and preferred.

1. List up to 10 present and past community, civic, religious, political, social, or other activities, in order of importance to you:
Organization Position(s) Held Dates

2. Describe any additional volunteer/community/state activities in which you would like to become active:

3. List any community awards or recognition you have received (up to five):
Award/Recognition Date

4. Describe a significant accomplishment in your community or civic activities:

5. What do you consider to be the three most pressing challenges facing North Carolina today?




6. What do you expect to gain from your participation in Leadership North Carolina, and what do you expect to contribute to both the program and to the State following your completion?

Letters of Recommendation
At least two (2) Letters of Recommendation are required.  They must be received by June 30, 2008 to be considered.  Letters should be addressed to the Selection Committee and sent to Leadership North Carolina via mail, fax or emailed to: brian@leadershipnc.org (email is preferable).  Letters must be sent directly from the author and will not be shared with the applicant.
 

Participant Commitment
Entering your name in the space below indicates that you have carefully read, and agree to, all requirements and instructions contained herein, and that you will commit the necessary time and resources to complete the program:
Name
 Date

Employer Commitment (if applicable)
Due to the time commitment, costs, and strict attendance policy, all applicants must have the full support of his/her employer.  By completing the information below, the applicant affirms that his/her employer endorses this application and is aware of these requirements.
Supervisor

 		Position
Company/Organization
 Phone
- -
Email

If the employer approval does not apply to you, please select the appropriate reason:

Application Fee
A non-refundable application fee of $35 is due by June 30, 2008.  Applications will be discarded if the fee is not received by that date.

Please indicate the method of your payment below.  When you click SUBMIT, a link will be provided with payment instructions for each of these options:
 
A check is being mailed under separate cover.
I will pay with a credit/debit card by phone.
I will pay with credit/debit card by mail, fax or online.
 
 Before clicking the SUBMIT button below, review your entire application for accuracy - it cannot be saved and re-submitted.  If you wish to retain a hard copy for your records, print before selecting SUBMIT.

I have reviewed my application and can attest to its accuracy.

Call the LNC office at 919.803.5323 if you have any questions about the submission process.
 

 

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