Leadership Missouri Scholarship Form
Through the generosity of the Leadership Missouri Alumni, we are offering scholarships for the 2020 Leadership Missouri program.

Award Value: The scholarship(s) awarded will total up to $1000 as determined by the Scholarship Committee. The amount awarded will be applied to the registration fees for the Leadership Missouri program.

Criteria: Scholarships will be awarded based on need. The Scholarship Committee on or before January 31, 2021 must receive applications for this scholarship. Any scholarship recipient unable to attend the Leadership Missouri program will forfeit the scholarship to an alternate, as selected by the Scholarship Committee.

The selection criteria for award of the scholarships are:

• Candidate’s potential for leadership
• Benefits to the candidate’s professional development
• Potential positive impact to the candidate’s organization
• Potential positive impact to the candidate’s community

Deadline to apply is January 31, 2021.

FOR MORE INFORMATION about Leadership Missouri, please contact:
Tammy Long
Director of Leadership Missouri
Phone: (573) 634-3511
Cell: (660) 238-4914
Fax: (573) 634-8855
Email: tlong@mochamber.com

Contact
Name *
Title
Current Company/Organization
Address *
City, State, Zip *
Phone *
Fax *
Cell Phone *
Email *
Home Address *
City, State, Zip *
Please describe your organization’s overall mission, purpose, activities and impact. *
Please explain why you are a good candidate for this scholarship. *
Please provide any additional information that you would like to bring to the attention of the scholarship committee. *
Will your participation hinge on receiving a scholarship? *
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