Leadership SCOTLAND Application
Leadership Scotland is a successful community leadership development program sponsored by the Laurinburg/Scotland County Area Chamber of Commerce. The program is designed to prepare citizens to expand their leadership roles and increase their knowledge of the Scotland County community. Community leadership skill development and a sense of trusteeship are integrated throughout the program.
Email address *
Name: Last, First and Middle (Nickname) *
Your answer
Birthday *
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Gender *
Required
Years in Scotland County *
Your answer
Home Phone
Your answer
Cell Phone *
Your answer
Spouses Name, Ages and Names of Children *
Your answer
Email *
Your answer
Current Employer *
Your answer
Date began with current employer *
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DD
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YYYY
Present Title/Responsibility *
Your answer
Address of current employer *
Your answer
Phone number of current employer
Your answer
Previous Employment
Include Employer, Title and Responsibility, Date of Employment
Also include any active military duty.
*
Your answer
What do you consider your highest responsibility, skill or career achievement so far? *
Your answer
Organizations and Activites
Please list in order of importance to you, up to five community, civic, professional, business, religious, social, athletic, and other organizations of which you have been a member:
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Your answer
Recognitions/Awards/Certifications
Please list any recognitions, awards and/or certificates you have recieved from your company or other organizations.
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Your answer
Education
Begin with high school, then college(s), business or trade schools and/or specialized training. Include dates attended and major(s).
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Your answer
General Questions
Are there particular LEADERSHIP skills that you hope to gain from this program? *
Your answer
How much time each month do you commit to community, civic, professional and other organizations and activities? *
Your answer
Have you been as active in community, and other activities as you like to be? *
If not, what have been the major barriers to your becoming involved?
Your answer
If you have previously not had time to or interest to become actively involved, what conditions have changed that now enable you to seek involvement in the community?
Your answer
Which volunteer agencies/organizations would you like to participate in during the next 12 months? *
Your answer
Have you participated in another community Leadership program? *
If yes, please specify which ones(s).
Your answer
What leadership course or seminars have you attended in the past 5 years?
Your answer
Please write a statement of why you wish to participate in Leadership Scotland and what you hope to gain from the experience. *
Your answer
Are you a registered voter? *
If no, please explain.
Your answer
In your judgement, what are the two (2) most important issues facing Scotland County today? Explain why and briefly suggest any recommendations for approaching and resolving these issues. *
Your answer
In your judgement, what is an issue that this community will be facing in five (5) years?
Your answer
Recommendations
Please list three (3) people who are knowledgeable about your leadership performance and potential. Include names, address, and phone number to contact.
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Your answer
Selection Criteria
Participants will be chosen for Leadership Scotland based upon the information provided in the applications. Consideration is given to leadership achievements, community involvement, overall accomplishments, recommendations from peers and employers, and the ability and interest in assuming additional leadership roles in the community.
Participant Commitment
The Leadership Scotland Program year will consist of 8 monthly full day sessions, including a trip to Raleigh, and an evening graduation program. Additional hours may be required for elective activities and other learning opportunities.

To successfully complete Leadership Scotland, a participant is expected to attend all sessions. Absences are excused with Steering Committee approval only in the event of an emergency or extenuating circumstance. A participant who is unable to attend all sessions may be asked to withdraw from the program and no portion of the tuition will be refunded. It is important that an applicant must have the full support of his/her employer to attend all sessions.

Please complete the signature page and attach it to email or bring it to the chamber office at 606 S Atkinson Street.
The application must be complete with the signature page and a recent snapshot photograph to be considered.

Please select yes that you understand the participant commitment. *
Required
Program Fees
Tuition is $500 for Chamber members. Tuition covers the cost of all class materials, lunches and graduation. A selection committee will screen applications. Companies/firms, civic clubs, non-profit agencies and foundations are urged to sponsor member of their management teams or individuals who have demonstrated potential leadership abilities. Sponsorship can be an important contribution to an employee's development and a company's growth, and will assure knowledgeable leaders for Laurinburg/Scotland County's future.

Enrollment is limited, it is important to act now.

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