Core Class Application Form – Leadership Lancaster

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2023 Core Class Program Application
First, let's get to know you
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*

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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 worked in Lancaster County?*

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Professional / Educational Information

Business / Organization Name*
Title*
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?*
- Advertising
- 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?

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References
References must be received through the online portal no later than Friday, May 27, 2022. Applications will not be considered complete without TWO accompanying references. We will not contact reference on behalf of any applicant.

Please indicate below the two people you have asked to complete the required confidential 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

Great work! Let's move on to a few short questions to get to know you better!

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

Community Leadership
What is your definition of community leadership?*
2 paragraph limit
Describe a characteristic of an individual who has personally 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 do you choose to work and/or live in Lancaster?*
2 paragraph limit
Identify one challenge currently facing Lancaster County and give an example of how you might contribute to the solution to this problem.*
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 aspect would you bring to the class?*
2 paragraph limit

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Commitment
Commitment must be completed by both the applicant AND the employer. 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 a learning experience that requires attendance at all program sessions and completion of assignments. The fall two-day retreat on September 8 and 9, 2022 is a mandatory portion of the program.
Leadership Lancaster recognizes and values the diversity inherent in the community we serve. We are committed to establishing space for meaningful dialogue as we develop a diverse group of leaders that is truly representative of Lancaster County. We are intentional in our efforts to recruit participants that are diverse, inclusive, and equitable. We welcome those who share this commitment and who wish to join with us in our work to develop effective leaders who are able to work collaboratively to serve the evolving needs of our community. We are inclusive of age, race, color, national or ethnic origin, sex, gender identity or expression, sexual orientation, family or domestic partnership or marital status, genetic predisposition, level of ability, religion, veteran status, or any other protected class. We acknowledge that this is a continuous journey, and it is critical to continue to listen, learn, and evolve. We promote, model, and expect respectful dialogue in all of our programs. When participants are committed to interacting respectfully with those who are different from themselves, their capacity for leadership is enhanced.
Applicant initial for agreement*

I agree to interact respectfully with those are different from myself. 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*

Upon successful completion of this program, I will actively engage with Leadership Lancaster.
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. Finally, I understand also that tuition is not refundable upon withdrawal from the program.
Applicant name*

By entering my name, I agree to all of the above items.

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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 work-release 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*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Employer/organization consent
Employer initial for consent*

The employer/organization is aware of the work-release time required, as stated in the Program Requirements/ Attendance Policy and dates listed below and endorses the applicant.

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Tuition commitment
Full tuition is $2,250. Each participant is expected to pay at least $150 of this amount. Due to fixed costs, tuition is not refundable should a participant withdraw at any time during the course. The company/organization/individual below indicates agreement to pay tuition by Friday, August 26, 2022 unless other arrangements have been made.
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
No applicant accepted into the program will be turned away for financial reasons. Payment plans may be arranged, and tuition assistance is available based upon need. Leadership Lancaster has a Scholarship Fund and can offer a limited number of partial scholarships for those participants who may require financial assistance. We also offer two full scholarships for diverse candidates from underrepresented backgrounds through the Truist endowment. 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, based on the five criteria listed in the Selection Process section above. 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/

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Almost there....
Before you hit finish, please take a minute to review what still needs to be submitted by May in order for your application to be considered: TWO completed references submitted online and scholarship form submitted online (if applicable).
Thank you for your interest in the 2023 Core Class!

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Search the Leadership Lancaster website

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First, let's get to know you

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

Employer/organization consent

Tuition commitment

Scholarship

Almost there....

Thank you for your interest in the 2023 Core Class!

Search the Leadership Lancaster website