Front Royal-Warren County Chamber of Commerce leadership front Royal-Warren County

Front Royal-Warren County Chamber of Commerce

LEADERSHIP Front Royal-Warren County

Building Community through Leadership
APPLICATION

Name____________________________________________________

Home Address______________________________________________

City________________________ State___________ Zip____________

Phone__________________________ Cell_______________________

Business Address____________________________________________

City_____________________________ State___________ Zip_______

Phone___________________________ Fax______________________

Email____________________________________________________

Years working in Front Royal-Warren County?________________

Years living in Front Royal-Warren County?_________________

EMPLOYMENT:

Present Employer _________________________________ Hire Date _______

_____________________________________________________________

(Present Title or Responsibility) (Since/Date)

Immediate Supervisor_____________________ Phone____________________

What do you consider your greatest career achievement to date?

EDUCATION: (Begin with high school, then college(s), trade schools and/or other specialized training.)
Name of School and Location Dates Degree Major
Special educational accomplishments, honors, recognitions, licenses or certificates.

CATEGORY:

Please check the one category below which best describes the area in which you presently work/serve.

 Community/Not-for-Profit  Corporate Business  Education  Financial

 Government  Professional  Small Business  Other ___________________

COMMUNITY INVOLVEMENT:

Please list up to five community, civic, professional, business, religious, athletic, social or other organizations or activities to which you have contributed leadership.

Organization Position/Assignment/Responsibility Dates
_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________
What have you accomplished or learned in these activities that you feel is important?

How much time each month do you commit to volunteer work?

If you have not been as active in community/professional/religious activities as you would like to have been, what were your major barriers to becoming involved? What has created your current interest or has changed to enable you to become more involved?

In your judgment, what are two significant opportunities and two major challenges facing Front Royal-Warren County today? Explain and include recommendations for taking advantage of these opportunities or for approaching and resolving these problems.

Opportunities:

Challenges:

A goal of Leadership Front Royal-Warren County is to build a network of community leaders who can enhance their problem-solving skills and other leadership abilities through shared perspectives and cooperative efforts.
What do you hope to gain for your participation in Leadership Front Royal-Warren County?

How would you use your Leadership Front Royal-Warren County experience to the long-term benefit of the community?

PERSONAL RECOMMENDATIONS:
Please list tw0 persons who are knowledgeable of your leadership performance and potential. You may submit one letter of recommendation.
Name_________________________________ Phone___________________

Name________________________________ Phone____________________

COMPANY COMMITMENT: (sponsoring organization/company)

This application has the company’s support to participate in Leadership Front Royal-Warren County. I am aware of the attendance requirements and of the time commitment of at least one full workday per month.

____________________________ _______________________________

Signature Organization/Company

____________________________ _______________________________

Title Date

Tuition for Leadership Front Royal-Warren County is $500

Applications are kept strictly confidential.

Please email [e-mail] mail or deliver completed applications along with your $100 deposit to:

Leadership Front Royal-Warren County

Chamber of Commerce

106 Chester Street

Front Royal, VA 22630

Leadership Front Royal-Warren County is a program of: