This application will be used to select participants for the Bingham Fellows Class of 2020. Please review the Program Calendar before submitting your application.


In addition to completing this application, please send a headshot photo via email to


If you are not a graduate of Ignite Louisville, Leadership Louisville or a former Bingham Fellow, please submit 2 recommendations, submitted via an online recommendation form or mailed to Leadership Louisville Center, 707 W. Main St., Louisville, KY 40202. 


You must complete the entire application in one session. Before beginning the application, we recommend you gather the information you need and compose the answers to the interview questions in another word processor (you can copy and paste into the application). 


Application deadline is Monday, October 21, 2019 at 11:59 p.m. If you encounter any problems submitting this form, please contact Peggy Clements at (502) 561-5228 or email

Name and Current Employment

Preferred First Name for permanent nametag*
Job Title*

In the address portion of this next section, please enter your business address.

Business Email*
Confirm Email*
Business Phone*

Your Assistant's Contact Information (optional)

Including an administrative contact's email address will ensure your assistant is copied on all class-related communications.

Assistant Phone
Assistant Email

Personal Contact Information

Home Address*
Home City*
Home State*
Home Zip Code*
Home email*
Mobile phone*
Spouse or Partner's Name


Diversity is an important part of our mission. Please provide the following information:

Date of Birth (mm/dd/yyyy)*
If foreign born, which country
Job Type - Explanation for Other
If not from Louisville, enter hometown city
Hometown State/Country

Tuition Support

Tuition support MUST BE REQUESTED at time of submission. NO requests will be considered after application deadline.


If not requesting a tuition support, skip to the next section, "Previous Employers."

Tuition support is available based on need; typically it is requested in situations where your employer is not able to fully or partially fund your participation. The Leadership Louisville Center does not fully cover tuition; requests can be for any amount but our awards typically do not exceed 50 percent of the program tuition, or $2,100.  Requests are considered only after the class selection process is complete and will not impact consideration of your Bingham Fellows application. To receive consideration, the following questions must be answered completely and accurately.

Amount of tuition support requested (dollar amount, no $ sign)
Why are you requesting tuition support?

Previous Employers

Please complete the following information for your two most recent previous employers, if applicable.

Previous Employer #1
Job Title (#1)
Previous Employer #2
Job Title (#2)

Awards & Recognitions

Please list any advanced degrees, awards and/or recognitions you have received.

Community Service

Please list up to three of your community service activities, beginning with the most recent.

Community Service - Organization #1
Community Service - Organization #2
Community Service - organization #3


Answers of 200 words or less per question are preferred. 

What areas do you think Louisville needs to work on to be a top tier city*
What skills, experience, or leadership would you bring to the Bingham Fellows Class of 2020?*
What personal or professional outcomes are you hoping to receive by participating in the Bingham Fellows program?*
Please list other leadership programs (including the year) in which you have participated (other than Leadership Louisville programs).
Beginning in May, Bingham Fellows participants form project teams and begin independent work on community solutions. Teams meet regularly outside of the program days and invest additional time implementing their ideas. It is only through the commitment of everyone in the class that projects can have an impact. Describe a time when you have worked on a team project and not everyone has pulled their weight – how was it addressed? How have you managed different types on conflict when working on a team?*


Please provide the names of the two individuals who will be submitting recommendations on your behalf. Instruct them to use the online recommendation form, which is linked on our Bingham Fellows page, 

Recommendation Name #1
Company (#1)
Title (#1)
Recommendation Name #2
Company (#2)
Title (#2)
How did you hear about this program? (check all that apply)
If referred by someone, whom can we thank for referring you?

Social Networks

This information is NOT used as part of the selection process. 

If selected, this information will be supplied to classmates to foster networking and communiction. Is it also used by the Leadership Louisville Center to recognize the class and individual members' achievements and program day activities.

We invite you to follow our social channels:

Facebook TwitterLinkedIn | Instagram

Instagram handle
Twitter handle


Please read and check box to confirm*
Please read and check box to confirm*
Please read and check box to confirm
Please read and check box to confirm*



After clicking the Submit button, it may take a few moments to process. If your application submitted successfully, you will see a confirmation message and receive an email within five minutes. If you do not see the confirmation page, please do not close your browser. Print the page and contact us as soon as possible at (502) 561-0458. 

Additional Comments


Share This Form

Powered by eTapestry