Core Class Application Form – Leadership Lancaster

Personal Information
Your Name*
First Middle Last
Preferred Name
Preferred Name
Preferred name for nametag, directory, etc.
Preferred Pronouns
Preferred Pronouns
(e.g. they/their, she/her, he/him, etc.)
Birth Date*

Personal Contact Information
Home Address*
Home Address Line 1 Address Line 2 City State ZIP Code
Cell Phone*
Personal Email Address*
Where are you currently living?*
How many years have you lived or worked in Lancaster County?*

Professional / Educational Information
Your Current Employer/Organization*
Job Title/Position*
Number of Years in Position*
Work Address*
Street Address Address Line 2 City State ZIP Code
Office Phone*
Office Email*
I prefer correspondence sent to:*
- Home
- Business / Organization
How did you learn about Leadership Lancaster?*
- Social Media
- Word of Mouth
- Co-Worker
- LL graduate
- Other
If LL graduate, please indicate who.
If other, please indicate how you learned about Leadership Lancaster.
Have you ever applied to Leadership Lancaster before?*
- Yes
- No
If yes, when?

Optional
Leadership Lancaster strives to build a diverse class to enhance everyone's experience and provide opportunity for all. Please answer the following questions as you feel comfortable.
Race / Ethnicity
- African American
- Asian / Pacific Islander
- Caucasian
- Hispanic
- Native American
- Other
- I do not wish to answer
Please check all that apply
If other, please expand.

Are there any other experiences you've had that you feel our selection committee should know about?

References
References must be received through the online portal no later than Friday, May 8. Applications will not be considered complete without accompanying references.

Please indicate below the two people you have asked to complete the references.*
Please provide the full name and title for reference one.
Please provide the full name and title for reference two.*
Please provide the full name and title for reference two.
Please share the following link with your references so they may complete and submit the form: https://leadershiplancaster.org/form/core-class-reference-form

Personal Information
In order for us to get to know you, please tell us a little bit about yourself.*
This can include your work, family, volunteer experience, hobbies, etc. 2 paragraph limit

Community Leadership
What do you think effective community leadership looks like and why does it matter?*
2 paragraph limit
Describe the leadership characteristics of a person who impacted your growth as a leader*
2 paragraph limit
Motivation for Applying
What is your prime motivation for applying to the Core Class and expectations for this program?*
2 paragraph limit
Commitment to the Lancaster Community
Why Lancaster County? Share what keeps you rooted here — whether through your work, relationships, passions, or sense of purpose. What makes this community special to you?*
2 paragraph limit
What community issues in Lancaster County most concern or inspire you? Why do these matter to you, and how do they impact the future of our community?*
2 paragraph limit
Contribution to the Strength of the Class
Leadership Lancaster classes are built of people with different backgrounds and life experiences. What unique perspectives would you bring to the class?*
2 paragraph limit

Commitment
You must have the full support of your employer/organization to apply regardless of financial support. Effective participation requires the approval and full support of an applicant’s organization including the time required to successfully complete the program.
Applicant initial for agreement*
Leadership Lancaster is an experiential learning program that requires your full commitment and attendance at all program sessions and completion of assignments. My employer supports my full participation in this program.
Leadership Lancaster values the diversity of our community and is committed to fostering meaningful dialogue and developing leaders in Lancaster County. We intentionally recruit diverse participants and welcome all who share our commitment to inclusion and collaboration in addressing our community’s evolving needs. Our inclusivity spans age, race, ethnicity, gender identity, sexual orientation, ability, religion, veteran status, and more. We model and expect respectful dialogue in all programs, recognizing that leadership grows through understanding one another. This is a continuous journey and we remain dedicated to listening, learning, and evolving as a community organization.
Applicant initial for agreement*
I agree to interact respectfully with classmates, presenters, LL staff and anyone I may come into contact with through the program. I agree to listen to, learn from, and create space for meaningful dialogue with my classmates, presenters, and staff. I understand that failing to do so may result in expulsion from the program without tuition reimbursement.
Applicant initial for agreement*
I understand that a $150 deposit is required within four weeks of notification of acceptance in order to hold my place in the Core Class. I also understand that tuition is not refundable should I withdrawal or be removed from the program.
Applicant name*
By entering my name, I agree to all of the above items.

Employer/organization commitment
Nominees for the Leadership Lancaster program must have the commitment of their employer or organization. The person listed below below is aware of the time required, as stated in the Program Requirements/Attendance Policy and dates listed below and endorses the applicant. For applicants who answer directly to a board of directors such as an executive director of a nonprofit organization, this would be the board president or chair.
Name of employer/supervisor*
First Last
Title*
Business/organization*
Email address for employer/supervisor*

Tuition commitment
Full tuition is $3,500. Tuition is not refundable should a participant withdraw at any time during the course. The company/organization/individual below indicates agreement to pay tuition within 45 days of notification of being accepted into the Core Class.
Employer/organization commitment*
The employer/organization agrees to pay the above listed amount on behalf of the participant.
Please invoice:*
First Last
Title*
Email address for invoice:*
Participant commitment*
The participant agrees to pay the above listed amount.
Scholarship
Leadership Lancaster has a Scholarship Fund and can offer a limited number of partial scholarships for participants who may require financial assistance. To apply for a scholarship, complete the online form. No requests for scholarship/financial assistance will be considered without this form completed by application deadline. Tuition assistance will be considered only after the applicant is selected. Request for financial assistance in no way influences the selection process.
Scholarship Request*
To submit a scholarship request, please cut and paste this link: https://leadershiplancaster.org/core-class-details/form/core-class-scholarship-form/

Almost there....
Before you hit finish, please take a minute to review what still needs to be submitted in order for your application to be considered: TWO completed references submitted and scholarship form submitted online (if applicable).
Thank you for your interest in the Core Class!

Search the Leadership Lancaster website

Personal Information

Personal Contact Information

Professional / Educational Information

Optional

References

Personal Information

Community Leadership

Motivation for Applying

Commitment to the Lancaster Community

Contribution to the Strength of the Class

Commitment

Employer/organization commitment

Tuition commitment

Scholarship

Almost there....

Thank you for your interest in the Core Class!

Search the Leadership Lancaster website