Leadership Thurston County
Class of 2019 Application
First Name *
Your answer
Last Name *
Your answer
Employer *
Your answer
Job Title *
Your answer
Ethnicity
Age
Highest Level of Education *
How long have you been with your current employer? *
How long have you lived/worked in Thurston County? *
What industry best describes your employer? *
What industry best describes your position within your organization? *
Phone Number (format as 360.357.8515) *
Your answer
Email *
Your answer
Mailing Address *
Your answer
Mailing City *
Your answer
Mailing Zipcode *
Your answer
Professional Reference: First & Last Name, Organization, & Phone Number *
Your answer
How did you hear about Leadership Thurston County? *
Your answer
What is your personal definition of community leadership? *
Your answer
What areas of the community you are interested in exploring from a leadership perspective? *
Your answer
What do you hope to gain from your LTC experience? *
Your answer
What are your expectations for the class? *
Your answer
I understand the tuition agreement to participate in LTC. Should I be accepted into the class, my employer &/or myself will make payment upon the receipt of invoice and no later then August 1, 2018, unless other written agreements have been approved. *
Applicant Supervisor Name *
Your answer
Applicant Supervisor Phone Number (format as 360.357.8515) *
Your answer
Applicant Supervisor Email *
Your answer
After you submit your application, please email the Program Commitment page to ltc@thurstonchamber.com. Your application will not be marked complete until this page is submitted.
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