LHC Class of 2027 Application

CONFIDENTIAL APPLICATION

This application must be submitted no later than 11:59 pm, November 1.

IMPORTANT NOTICE TO APPLICANTS

Participation in each Leadership Hendricks County (LHC) class is limited, and we have learned that our classes are most successful when they represent a balanced geographic and demographic cross section of Hendricks County. Applications are reviewed by a selection committee using a point system, without considering the identity or employer of individual applicants. The selection committee uses this application as its sole source of information about you, so it is in your best interest to answer questions carefully and thoroughly. If you are not selected for this year's class, it is not a negative statement about you or your accomplishments. We encourage applicants who are not chosen to apply again for future classes. Participants must live, work, or have a vested volunteer interest in Hendricks County. The two primary reasons applicants are not selected are the quality of the application and the desire to have a cross-section of the county and occupations.

LHC is committed to the full inclusion of all qualified individuals without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. As part of this commitment, LHC will ensure that persons with disabilities or those who require other forms of assistance are provided reasonable accommodations. If reasonable accommodation is needed to participate in the program or application process, please contact Leadership Hendricks County by calling 317-718-6075 or emailing jmorrison @leadershiphendrickscounty.org. Reasonable accommodations may include but are not limited to alternative format for submitting essay responses or scribe for completing online form.

PROGRAM DESCRIPTION

Leadership Hendricks County, Inc. is a year-long seminar program designed to identify, educate, motivate and develop a select group of area citizens for positions of community leadership. Participants are selected on the basis of demonstrated interest to learn more and engage in the community, as well as desire to grow in their leadership. Please see the LHC Adult Program Policies at www.LeadershipHendricksCounty.org for additional information.

General Information

First Name

Last Name

Personal Pronouns

Informal / Nickname

Birth Date

Race/Ethnicity

Spouse's Full Name

Preferred Address

Home Address

Home City

Home State

Home Zip Code

Home Township

Work Address

Work City

Work State

Work Zip Code

Preferred Phone

Cell Phone

Work Phone

Preferred Email

Work Email

Personal Email

Employment

Present Employer

Position/Title

Industry

Work Address

Township

City

State

Zip Code

What type of leadership position are you currently in?

Do you have your employer's full support for the time required to participate in LHC?

Please list other employment history

Company Name

From

Education

High School

Location

Diploma Received?

Yes

College / University

Location

Type of Degree / Major

Degree Received?

Yes

Certification Received

Issuing Institution

Year

Activity Data

Please list community boards, committees, social, professional or trade organizations you have been involved with:

Organization

Role/Leadership Position

Years Involved

If you have previously not had time or interest to become actively involved, why are you now seeking involvement in the community?

Applicant Statement (max 200 words for each question)

What do you expect from LHC Ignite Community Leaders program?

Why do you wish to participate in LHC Ignite Community Leaders program?

In your opinion, what are the two greatest challenges currently facing Hendricks County and its communities? What recommendations would you make for solutions?

How do you feel you can contribute to the community?

How did you learn about Leadership Hendricks County?

HEADSHOT & BIO

Please give us a 200-word maximum biography. Talk about yourself as you might see it in a news article and include things like where you came from, your family, hobbies, past work experiences, etc. Upon your acceptance, we will use this in our class as well as an insert into our newsletters to introduce you to our network of leaders.

Please upload a recent headshot to be used upon acceptance to the class.

TUITION

Tuition for Leadership Hendricks County is $1,800. Financial assistance is available with preference given to nonprofits, government agencies and small business owners. Any requests for financial assistance will be kept confidential.

Who should the tuition invoice be sent to?

Name

Address

Financial Assistance Requested?

AGREEMENT

I have reviewed the LHC Adult Program Operating Policies (found at www.LeadershipHendricksCounty.org) and understand the Participant Commitment as stated on pages 4-6.

I understand that successful completion of this program requires complete attendance at the opening and closing retreat and at least seven of the nine monthly sessions. In addition, active participation in a Capstone Project WILL require additional meetings. This agreement warrants that, if my application is accepted, I will be able to devote the time and financial resources required to accept placement into this year's class. I also understand that successful applicants are responsible for the tuition of $1,800. I agree not to hold Leadership Hendricks County, Inc. legally liable for any injuries or illness received during my participation, and give my permission for photographs and videos taken of me during LHC activities as well as any quotations I give, to be used for public relations and marketing efforts on behalf of LHC.

I agree to the terms listed above

Participation in each annual Leadership Hendricks County class is limited and based on a thorough, well-written application. The organization strives to select a balanced geographic and demographic cross-section of Hendricks County from among all qualified applicants. Candidates who are not selected are encouraged to apply for future classes.

Questions? Visit www.leadershiphendrickscounty.org, call 317-718-6075 or email jmorrison @leadershiphendrickscounty.org.

Contact Information