Leadership Development Training Application Name* First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Direct or Mobile PhoneEmail Company Name Business Phone NumberBusiness Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this applicant being sponsored by their employer?YesNoSponsoring Employer (if applicable) Contact at Sponsoring Employer First Last Sponsoring Contact Email Sponsoring Contact PhoneDate of Hire MM slash DD slash YYYY Applicant's Occupation/Title Essay SectionPlease provide an updated resume, letter of recommendation from current employer and complete essay questions.Describe a time when you had the opportunity to exercise your leadership skills. Include a description of your professional and/or community involvement.*What leadership skills or characteristics do you hope to develop through participation in the WKLD Program?*Please explain why you would like to assume a leadership position and/or increase your influence.*What type of leadership positions or level of influence would you be most interested in becoming actively engaged in?*Why do you want to participate in the WKLD Program?*Signature*I understand the purpose of the WYOMING KENTWOOD LEADERSHIP DEVELOPMENT PROGRAM and if I am selected, I will devote the time and resources necessary to fully participate in the program. I understand that the training sessions will be held at various locations within Wyoming and Kentwood. Full participation is expected for all sessions, projects and interim activities. If it becomes necessary to take time off from work to participate in this program, I will obtain the proper approval and authorization prior to committing to this program. Failure to comply with this policy will result in dismissal from the program and forfeiture of the registration fee. If you and your employer (if applicable) are unable to make this commitment, it is not appropriate to apply. Your signature indicates you are willing to make such a commitment.NameThis field is for validation purposes and should be left unchanged.
