2019-2020 CNC Class Application
The mission of Connecting Nicollet County: CONNECTING PEOPLE, CREATING AWARENESS AND BUILDING LEADERSHIP THROUGHOUT NICOLLET COUNTY

Applications received through June 15, 2019 will have a $450 tuition rate
Applications received after June 15, 2019 will have a $475 tuition rate
Please note that actual program costs total over $1,100, but thanks to generous donations, we are able to keep tuition costs low.

Applicants must be able to commit to 7 of the 9 sessions in order to participate in graduation.

Sessions are held the second Thursday of each month - September through May.

First Name *
Your answer
Last Name *
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
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Zip *
Your answer
Personal Email *
Your answer
Cell Phone *
Your answer
Employer Name *
Your answer
Your Job Title *
Your answer
Employer Mailing Address (include City, State & Zip) *
Your answer
Supervisor Name *
Your answer
Supervisor Email *
Your answer
Please list your home town *
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Please list family members *
Your answer
Please list your current community involvement and any leadership roles held *
Your answer
What are you hoping to gain from your time in Connecting Nicollet County? *
Your answer
Please list any hobbies or relevant experience you would like to share *
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By checking this box, you agree to having your name published on our website, social media, and other public media for marketing and communications purposes. *
Required
Some tuition assistance may be available on a case by case basis. Do you need tuition assistance? *
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By checking this box, I understand that submission of this application does not guarantee acceptance into this program. I also understand the expectation to attend 7 of the 9 scheduled sessions in order to participate in graduation. *
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Please type your name below. Your typed name will serve as electronic signature of this form. *
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