Women's Leadership Circles of Vermont Winter Application
Welcome! We are now accepting applications for the Women's Leadership Circle of Waterbury/Stowe, set to begin in January of 2018.

Our application process is designed to ensure a good fit between applicant and program. The Women’s Leadership Circles of Vermont support powerful women across sectors. Successful participants have the initiative and vision to push themselves toward greater personal and professional achievement and to grow in their roles as influential change-makers. To explore the fit, we recommend that you have a conversation with Lisa Christiet before you complete the application. She can be reached at (802) 451-0842, or via email at ksecrest@gradschool.marlboro.edu.

Please note that it is not possible to save this application in progress. We recommend you review the entire application and type out the answers to the essay questions in a separate word processing program, and then cut and paste the replies into the form when you are ready.

Applications are due October 30, 2017 for the Early Bird discount. Final Application deadline is November 24, 2017.

First Name *
Your answer
Last name *
Your answer
Contact Information
Home Phone *
Your answer
Mobile Phone
Your answer
Email address *
Your answer
Mailing address *
Please include your city and zipcode.
Your answer
Work Information
Work title/ position *
Your answer
Company *
Name of company or organization.
Your answer
Work Address *
Street address, city, state and zip of your company or organization.
Your answer
Work Phone *
Your answer
Work Email *
Your answer
Resume
Leadership Roles *
Please list your volunteer and professional leadership roles held in the past 5 years.
Your answer
Educational Attainment *
Please list your degrees, year earned, and institution. Include other leadership institutes and certificates.
Your answer
Awards
If you have received any awards, honors or recognition for your leadership, please tell us about them.
Your answer
Memberships
List your memberships (eg Rotary, a faith community, professional organizations, etc).
Your answer
Unexpected Skills *
Share 2 talents you have that don't necessarily show up on your resume (eg waterskiing, knitting, speaking Japanese).
Your answer
Reference #1 *
List a reference who can speak to your leadership skills. Include their name, phone number, email, and a brief description of how they know you.
Your answer
Reference #2
List a second reference who can speak to your leadership skills. Include their name, phone number, email, and a brief description of how they know you.
Your answer
Longer Answers
The application includes three longer answers. Each answer can be anywhere from a paragraph to a page long. Please take some time to think about these questions. You will probably want to draft your replies in a word processing program and then copy and past them into the answer boxes.
State of the self *
What is your life situation right now? Please share where you are professionally and personally at this moment in your life. What is most important to you? What questions are you asking yourself? What is going well, and what - if anything - is holding you back?
Your answer
Leadership journey *
Describe your most meaningful leadership experience from the past couple years. Why was it important to you and what did you learn?
Your answer
Why WLC, and why now? *
Why is this the right time for you to participate in the WLC? What would make it worthwhile for you?
Your answer
Demographics
We collect this information for research and statistical purposes only.
Year of birth
Your answer
Hispanic identification
How would you describe yourself?
Race
Gender
Veteran Status
Logistics
Date Conflicts
Please review the following session dates and mark any dates you absolutely can NOT attend.
Dietary Preferences
We will work to accommodate your dietary needs for our retreat meals. Please describe any dietary preferences (check all that apply).
Interference
What might interfere with your ability to participate fully in your personal and professional development during the six months of the program?
Your answer
Last words
Agreements - please initial in box below. *
I give Marlboro College and Kerry Secrest permission to use data I provide to report outcomes of the program proposals for future funding of the program, and articles on women’s leadership. I, also, grant Marlboro the right to use, reproduce, and/or distribute quotes, photographs, films, videotapes, or sound recordings of my participation with Women’s Leadership Circles of Vermont for use in any informational or promotional materials they may create. There will not be any financial payment to me for use of these materials. I understand that if Marlboro wants to use my name for specific quotations, they will ask me for permission. I will hold Marlboro harmless of any claims and/or liability based upon my involvement and participation in activities of the Women’s Leadership Circles of Vermont.
Your answer
How did you hear about WLC? *
Your answer
Thank you!
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