Leadership Hardee Application
Email address *
Last Name:
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First Name:
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Employer:
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Job Title:
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Home Address:
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Business Address:
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Cell Phone:
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Business Phone:
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Employment Information - Present Employer:
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Start Date:
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Job Title:
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Briefly describe your greatest responsibility, skills and/or career achievement:
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Reference #1) Name/Title: Relationship: Phone:
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Reference #2) Name/Title: Relationship: Phone:
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I agree to pay the asked amount of the Leadership Hardee tuition for the applicant if accepted. I understand the tuition is nonrefundable and nontransferable. Signature (Type out full name):
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Date:
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Have you participated in another Community Leadership program?
If yes, please list the program(s) and the year(s) of participation:
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Have you applied to Leadership Hardee in the past?
How did you learn about Leadership Hardee?
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Highest Degree of Education - Name Of Institution:
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Location:
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Degree/Major
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Year
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COMMUNITY CONNECTIONS Please list, in order of importance to you, your business/professional affiliations, as well as involvement in civic organizations, business & community board service, and volunteerism.
Organization / Activities / Position / Date of Membership
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ESSAY QUESTIONS Keep in mind that your answers are the only tool the Selection Committee has to learn about you, as we do not conduct interviews or accept letters of recommendation. Give yourself enough time to complete the questions thoughtfully.
COMMUNITY VISION: What assets and strengths do we have in Hardee County that you are proud of?
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Which challenge(s) facing Hardee County are you most passionate about, and why?
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PERSONAL STATEMENT: Why do you want to participate in Leadership Hardee? Why should you be selected for Leadership Hardee Class 2019?
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Application Agreement If Accepted:
APPLICATION CHECKLIST:
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