Leadership Gilmer Application

Before starting your application, please read the Leadership Gilmer Program Overview

Part 1: Policies and Requirements

Application Deadline: Tuesday, October 24, by 5:00 PM.
Tuition: Tuition is $650 for Chamber members (paid by either employer or applicant). Once your application is accepted into the program, full payment will be required by December 1^st.
Applications will be deemed incomplete if questions from the application are not answered.
Applicants must not be an announced candidate for public office at the time of application to the program.
Applicants must have their employer’s support for participation due to time involved to complete the program.
Participants of Leadership Gilmer 2024 are expected to attend all scheduled meetings of the program. Participants who miss more 2 days of the program will be dropped from the program. There will be no appeals process or refund of the program fee.

Leadership Gilmer Application

Part II: Personal Information

Applications should include Policies & Requirements, Personal Information, and Questions. The information submitted with this application is true and correct to the best of my knowledge. I have read and understand the requirements and will comply if selected for the program.(Required)

I agree to the commitment policy.

Applicant Signature(Required)

Date(Required)

Employer Confirmation(Required)

I agree to the commitment policy.

This applicant has the full support of his/her employer for participation in the Leadership Gilmer program. Further, this employer fully understands the time commitment and attendance policy of the Leadership Gilmer program. Signature from you and your employer is required! If you are self-employed, please state below.

Employer's Signature(Required)

Date(Required)

Employer's Name(Required)

First Last

Phone Number(Required)

Please complete the following information:

Name(Required)

First Last

Preferred Name for Nametag(Required)

First Last

Work Phone(Required)

Cell Phone(Required)

Home/Personal E-mail(Required)

Business/Organization E-mail(Required)

Preferred Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Employer(Required)

Job Title(Required)

Business/Organization Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Shirt Size(Required)

Men's or Women's/ S, M, L, XL, XXL, etc

Part III: Questions

1. Current Employment: Length of Service with present business/organization. Briefly describe your responsibilities, i.e. are you a business owner? How many employees do you supervise? Etc.(Required)

2. What do you consider your highest responsibility, skill or career achievement, so far?(Required)

3. Education (college, trade, etc.) List dates attended and degrees obtained.(Required)

4. Organizations and Activities. List community, civic, professional, business, religious, social, athletic, and other organizations of which you have been a member, in order of their value to you, during the past five years. How many hours per month are currently committed to community, civic, professional, and other organizations, and activities?(Required)

5. What do you hope to gain from and/or contribute through your involvement in Leadership Gilmer?(Required)

6. In your judgment, what are three pressing challenges facing our community today?(Required)

7. What qualities do you possess that make you a current or potentially effective leader?(Required)

8. What other things should the selection committee know about you to make an intelligent decision about your application for the Leadership Gilmer program?(Required)

9. Name two people in this community whom the selection committee will contact for additional information about you. Please list their names, business, title, address and phone.(Required)

CAPTCHA

Application Deadline

Please Submit your Leadership Gilmer Application by Tuesday, October 24, 2023.

View or download a PDF version of the application