IGNITE LOUISVILLE APPLICATION

 

This application will be used to select participants for the Ignite Louisville classes that begins in April 2019 and October 2019. Please review the Program Calendar for the class before submitting your application.

 

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 a word processor (you can copy and paste into the application). 

 

Application deadline is Monday, February 18, 2019 at 11:59 p.m. If you encounter any problems submitting this form, please contact Peggy Clements at (502) 561-5228 or email lead@leadershiplouisville.org.

Name and Current Employment

Preferred first name for permanent nametag*
Job Title*
Company*


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

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Business Email*
Confirm Email*
Business Phone*

Personal Contact Information

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

Demographics

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

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

Scholarship

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

 

If you are requesting financial assistance to participate in this program, please note that while we are able to offer financial assistance, the Leadership Louisville Center does not provide full scholarships. To receive consideration, the following questions must be answered completely and accurately.

 

Scholarship must be requested at time of submission. NO requests will be considered after application deadline.

Dollar amount of scholarship requested (no $ sign)
Why are you requesting a scholarship?

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)

Education

Please list any degrees you have received.

Undergraduate Institution
Undergraduate Degree/Major
Graduate School
Graduate School Degree/Area of Study

Awards and Recognitions

Please list any awards and/or recognitions you have received. If you are a graduate of the YPAL Emerging Leaders or Fund for the Arts NeXt program, please indicate that here.

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

Interview

Describe your current position in 30 words or less*

For the next two interview questions, answers of 100 words or less per question are preferred.

Tell us what leadership skills you hope to improve from your participation in Ignite Louisville?*
What life experiences and perspectives do you bring to the class that would make you a unique participant?*
In your own words, explain the value the Ignite Louisville Challenge brings to the community. Include your own capacity - in terms of time - to make the team project successful. *

Other Information

The following is information we need for advance program planning purposes. 

What are your top three skills? (one skill per field)

Top skill #1: 1-2 words*
Top skill #2: 1-2 words*
Top skill #3: 1-2 words*

Recommendations

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 Ignite Louisville page, www.leadershiplouisville.org/ignite-louisville. 

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)*
  • Brochure or marketing materials
  • Community Event
  • Email from Leadership Louisville Center
  • Leadership Louisville Center event or program
  • Leadership Louisville Center website
  • News story or ad in media (TV, newspaper, magazine)
  • Online or social media (Internet, Facebook, Twitter, LinkedIn, Instagram)
  • Suggested by employer/colleague
  • Referred by friend or family member
  • Referred by program graduate
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 communication. It is also used by the Leadership Louisville Center to recognize the class and individual members' achievements. 

Twitter handle
Instagram handle

Commitment

Please read and check box to confirm*
  • I understand that participation in the Ignite Louisville program requires a commitment to attend each of the monthly sessions in their entirety. Review the program day dates here: https://www.leadershiplouisville.org/ignite-louisville/#calendar
Commitment - opening retreat*
  • I understand that the opening retreat for the April - Oct 2019 class will run from the morning of Thursday, April 25 through 5 p.m. on Friday, April 26. I understand the opening retreat for the October 2019 - April 2020 class will run from the morning of Thursday, October 10 through 5 p.m. on Friday, October 11, 2019. I understand it is required that I am present for the entire two-day event. Missing any part of the opening retreat will disqualify me from the program.
Please read and check box to confirm*
  • I understand that missing more than one program day (or equivalent hours) could result in dismissal from the program.
Please read and check box to confirm*
  • I understand that a major component of the program is the Ignite Louisville Challenge, which is a small group community service project that puts my leadership learnings into practice. This project will require significant time outside of program days, and it is mandatory that each participant is actively engaged with his or her project. More information about the Ignite Louisville Challenge can be found here: https://www.leadershiplouisville.org/ignite-louisville/ignite-louisville-challenge
Please read and check box to confirm*
  • I understand that to commit to the Ignite Louisville program and the Ignite Louisville Challenge will require support from my employer, family and other obligations. The program is only successful when all participants are committed to its completion.
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