LEADERSHIP LOUISVILLE APPLICATION

 

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

 

The application process includes this online application, 2 recommendations (submitted via an online recommendation form), and a headshot photo (emailed to ajewell@leadershiplouisville.org).

 

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, May 13, 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 (note: a blank space at the beginning or end of an email address can cause an error.)*
Confirm Email*
Business Phone*

Your Scheduling Assistant/Admin's Contact Information (optional)

Including a scheduling assistant/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 and Demographics

Diversity is an important part of our mission. In an effort to understand our applicants and ensure all populations are served, we have a few questions we’d like to ask. Please know that:

  • This information is used to collect demographic data on our applicants.
  • The information will not be used for a discriminatory purpose.
  • Only Leadership Louisville Center staff and the selection committee will have access to this information.

Your responses will be kept private and secure.

Date of Birth (mm/dd/yyyy)*
Gender*
Job Type - Explanation for Other
If not from Louisville, enter Hometown City
Hometown State
If Foreign Born, name 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.

Amount of scholarship requested (dollar amount, 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.

Awards and Recognitions

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

Answers of 100 words or less per question are preferred.

The mission of the Leadership Louisville Center is to inspire and equip leaders to be better and do better. What is your personal philosophy regarding community service and how have you demonstrated this through leadership?*
What life experiences and perspectives do you bring to the class that would make you a unique participant?*
What have you experienced in other Leadership Louisville Center programs, or what do you know about the work of the Leadership Louisville Center, that makes you excited to be part of the Leadership Louisville program?*

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 Leadership Louisville page, 
https://www.leadershiplouisville.org/leadership-louisville-recommendation-form/ 

Recommendation Name #1*
Company (#1)*
Title (#1)*
Recommendation Name #2*
Company (#2)*
Title (#2)*
How did you hear about this program?
  • 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)
  • Referred by friend or family member
  • Referred by program graduate
  • Suggested by employer/colleague
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 affirm that this information is accurate at the time of this submission. If it changes, it is my responsibility to notify Aimee Jewell (502) 561-0458, or it may invalidate my application.
Please read and check box to confirm*
  • I understand that participation in the Leadership 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/leadership-louisville/#calendar
Please read and check box to confirm*
  • I understand that the opening retreat will run from the morning of Thursday, August 15 until 5:00 p.m. on Friday, August 16. The retreat will take place in Lexington, KY. 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 two program days (or equivalent hours) could result in dismissal from the program.
Please read and check box to confirm*
  • I understand that to commit to the Leadership Louisville program will require support from my organization, family and other obligations. The program is only successful when all participants are committed to its completion.

 

IMPORTANT - PLEASE READ!

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. 

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