2024-2025 Leadership New York Interest Form

Thank you for your interest in the Leadership New York program!

Sign up below to stay connected and receive early updates on the application cycle starting in the spring. We review the registration list quarterly, so it may take some time for us to respond if you request contact. For immediate questions, email Program Manager Shuba Maniram at Shuba@coronewyork.org.

First name

Last name

Pronouns (check all that apply)

She/herHe/hisThey/theirOther

Phone number

Employer (If not applicable, please write NA or TBD)

Job title

I have questions and would like to speak about this program with a Coro representative.

Yes!

Referral source (specific name):

Were you referred to LNY through CoreNet?

YesNo

Have you applied to LNY before?

YesNo

Contact Information