LEAP - MENTOR Application
YOUTH LEADERSHIP MENTOR APPLICATION
The Youth Leadership Initiative, LEAP, is a program sponsored by the Leadership Pocatello-Chubbuck Chamber of Commerce. LEAP is a one year program, with an opportunity for the students to mentor the second year. A new class will start each year in October. The program year involves attending one full day class each month where mentors will teach and facilitate to the students leadership training and learn about the community. Days may include but subject to change,
topics like Industry Day, Healthcare Day, Judicial Day, Law Enforcement Day, Government Day, Social Services Day and more. There is also a curriculum identified as part of the program to be utilized by the mentors.

*If you have Graduated from the Pocatello - Chubbuck Chamber of Commerce Leadership Program and qualify as a Leadership Alumni please apply accordingly.

Applications are due by November 15th, 2018
Please return applications to the Pocatello-Chubbuck Chamber of Commerce at 324 South Main, Pocatello ID, 83204

Or email Attention: Deb Beckett at dbeckett@pocatelloidaho.com AND Attention: Rainbow Maldonado at rainbowjurnee@gmail.com

Any questions please call the Chamber at 1-208-233-1525 or Rainbow Maldonado directly at 1-208-241-7269.
Applications may also be mailed to PO Box 626, Pocatello ID 83204

Personal Information
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Street Address *
Your answer
City, State *
Your answer
Zip Code *
Your answer
Employer’s Information
Leadership Pocatello-Chubbuck may contact your employer to verify consent to your participation in the program.
Employer (Comany Name) *
Your answer
Business Email - Applicants *
Your answer
Business Phone - Applicants *
Your answer
Business Address - Applicants *
Your answer
Do you have full support of your employer for the required time to participate effectively in the LEAP Mentor program? *
Class Dates
December 2018 - TBD - Introduction
January - Tuesday 8th, 2019
February- Tuesday 12th, 2019
March - Tuesday 12th, 2019
April - Tuesday 9th, 2019 & Leap Leadership Graduation
May - 16th, 2019 - Elevate Leadership Summit
Elevate Leadership Summit
This will be included for our youth students to be invited to attend this summit on May 16th, 2019 as well as our mentor participation.

The Elevate Leadership Summit (ELS) increases networking and collaboration opportunities, educates professionals on leadership and development skills, and provides opportunities for innovation and implementation in your organizations. It fosters collaboration between managers and their employees, encourages the development of new ideas at all levels, and allows attendees to effectively align strategy with execution.

Organizations/Activities/Community Involvement

Please list, in order of importance to you, the major civic, business and professional activities in which you have participated during the last five years, here or elsewhere. For each activity, indicate the nature of your participation including any offices that you have held and any awards or special recognition that you have received. If you have not been involved, please explain why.
Organizations / Activities *
Your answer
What do you consider your highest responsibility, skill or career achievement so far? *
Your answer
Why do you want to participate in, and what do you hope to learn from LEAP Leadership Pocatello-Chubbuck? *
Your answer
#1 - What three priorities would you like to see addressed for our youth in leadership in the Pocatello-Chubbuck area? *
Your answer
#2 - What three priorities would you like to see addressed for our youth in leadership in the Pocatello-Chubbuck area? *
Your answer
#3 - What three priorities would you like to see addressed for our youth in leadership in the Pocatello-Chubbuck area? *
Your answer
Special Needs?
If yes, please expalin *
Your answer
Name Badge & Shirt Size *
Your answer
How would you like your name to appear on your name badge? *
Your answer
For sizing purposes would you like a Men’s or Women’s shirt? *
Shirt Size please indicate - select one only *
Electronic Signatures
All applicants will be given full consideration

Leadership participants are representatives of the Leadership Pocatello­-Chubbuck program and the Pocatello­-Chubbuck Chamber of Commerce. Leadership requires and expects the highest level of professionalism from each participant. The Leadership Alumni Association Board of Directors will consider any participant who does not demonstrate professionalism during a class or a Leadership event for dismissal. (See Code of Professional Conduct)

Code of Professional Conduct
Personal Conduct:
Leadership Pocatello-Chubbuck expects all participants to demonstrate the utmost professionalism while attending Leadership functions. The Leadership Board of Directors will consider anyone who displays inappropriate conduct for immediate dismissal.

Courtesy Policy:
All Leadership Pocatello­-Chubbuck participants must be respectful and courteous when attending functions. Participants are expected to attend all classes and remain in class the full day, if other arrangement must be made, contact your Board Members and other Mentors.

Appearance/Dress Code:
Leadership Pocatello­Chubbuck expects all participants to use good judgment and taste in matters of personal grooming and dress. A professional appearance is vital to the program's image.

Alcohol:
The use of alcohol at the LEAP Leadership Pocatello-­Chubbuck functions is forbidden.

Smoking Policy:
Leadership Pocatello­Chubbuck is sensitive to the needs of its participants, volunteers, and visitors. Because there is evidence that smoking and second hand smoke poses significant health threats, the use of cigarettes, cigars, pipes, and other smoking paraphernalia should be used in accordance with the facilities procedures. Each facility visited will have its own policies regarding employee smoking, please follow these policies as if you were employed there during our visit.

Social Media Policy:
All uses of social media shall be in support of the Chamber and Leadership Pocatello/Chubbuck in the furtherance of the stated goals of the Chamber and Leadership Pocatello/Chubbuck, for a legitimate business purpose. The Chamber reserves the right to monitor, inspect, copy, review and store, at any time without prior notice, any and all usage of social media and any and all information transmitted or received in connection with such usage. Permission and or approval upon minors guardians.

Fingerprint and Background check - Required
Once an applicant is chosen it will be their responsibility to go to the Administrative offices of School District #25 and pick up the school districts fingerprint and background check packet. This will need to be done within 5 business days of application acceptance. *There is a fee associated with this.
Applicant’s Signature
Please enter your full name below.
By typing your name in the space provided below you are signing this application. You understand that if you are selected to participate, you must have the time to complete the LEAP Leadership Pocatello­-Chubbuck program. You also understand that you will be expected to use the information you gain from the program for the benefit of the Pocatello­ Chubbuck area. * *
Your answer
LEAP - OBJECTIVE

The Youth Pocatello Leadership Program, LEAP, introduces and enhances leadership skills among high school students within Pocatello, Chubbuck, and surrounding areas. Through mentoring and leadership opportunities we can enhance and encourage involvement within all levels of the community life.
LEAP - MISSION
Provides opportunity for youth to participate in meaningful change, to learn basic networking skills, and to grow as individuals. LEAP develops committed leaders by encouraging community participation. It helps youth learn skills necessary to create a community where they want to invest in their futures both personally and professionally.
LEAP - VISION

Inspiring participants to impact their community through networking, community engagement, and continuous leadership both professionally and personally. It will connect young adults to organizations and businesses in the Greater Pocatello & Chubbuck areas where they can seek out volunteer opportunities and engage in local leadership.
LEAP - VALUES

- Students will develop stronger leadership skills through robust curriculum taught by skilled facilitators.
- Gain an awareness of the need for community service, civic participation, and philanthropy.
- Increase familiarity with Pocatello & Chubbuck areas beyond their immediate neighborhoods and school.
- Interact with adult leaders in businesses, non-profit organizations, and public sectors.
- Aquire a network of adult and youth leaders in the Pocatello & Chubbuck area which can form an
excellent basis for their success in the workforce and higher education world.
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