Scholarship Application 2018-2019
APPLICANT INFORMATION
First Name *
Last Name *
Cell Phone *
EMPLOYMENT INFORMATION
Employer *
Employer Mailing Address *
Employer City *
Employer State *
Employer Zip *
Employer Phone *
Work Email *
No. of Employees *
No. of Employees in Johnston County *
Total budget allocated to Professional Development *
Has anyone in your organization participated in Leadership Johnston? *
If Yes, how many?
Has anyone from your organization received a Leadership Johnston scholarship?
Describe your organization's commitment to professional development. *
YOUR PROFESSIONAL DEVELOPMENT
Have you ever participated in a leadership program? *
If Yes, please describe. *
Could you still participate in Leadership Johnston if a scholarship were not awarded? *
YOUR CAREER GOALS
What are your career goals? *
Why do you feel you deserve this scholarship? *
STATEMENT OF UNDERSTANDING
I understand that if I am selected to receive a Leadership Johnston scholarship, I must complete the program in its entirety as outlined in the program requirements. If I am unable to complete the program as outlined, the scholarship must be repaid. If I am awarded the scholarship and am unable to participate, I will provide written notice no less than one week prior to orientation so that the Leadership Johnston Scholarship Committee may offer my scholarship funds to another qualified applicant.
Additional support materials/documentation may be submitted along with this application, which can assist the Scholarship Committee in making its selection.
APPLICATION AGREEMENT
By submitting my application and all required documents, I agree to commit to the STATEMENT OF UNDERSTANDING as described. Scholarship application will not be accepted without PROGRAM APPLICATION.

APPLICATION DEADLINE: July 31, 2018

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