LEADERSHIP KAUFMAN COUNTY

APPLICATION

Leadership Kaufman County is seeking applicants for 2009 – 2010 year. 

KCLC, its parent organization, is made up of Kaufman County elected officials, school superintendents, city managers, mayors, chamber officials and economic development corporation officials throughout the county dedicated to the future growth of Kaufman County.

Tuition $350.00 (If received by 9/15/09) Late fee will be assessed on 9/30/09.

CONFIDENTIAL APPLICATION FOR SELECTION

APPLICANT NAME _________________________ DATE _____________________

SPONSORED OR REFERRED BY: ________________________________________

APPLICATION

Leadership Kaufman County is seeking individuals that can develop into future leaders for our community.  The intent of the program is to develop new community leaders and enhance the skills and community awareness of existing community leaders.  The goal of the process is to assemble a diverse group of individuals with a common interest in leadership.

Selection Criteria

A.     Evidence of community citizenship

B.     Evidence of professional leadership and commitment in your respective craft/business career

C.    Evidence that an applicant is seeking long term involvement in Kaufman County with the intent to serve on boards, commissions, or any volunteer leadership roles.

 Acceptance into the program is based on a subjective assessment of the information each applicant provides in this application.  It is critically important to diligently answer the entire application.  Because there are typically more applicants than can be accommodated in each class, applicants who are not accepted are encouraged to reapply.

Please type or print application. (Please no resumes)  Completed application must be submitted to your Chamber of Commerce or P.O. Box 146, Kaufman, TX 75142 by September 1, 2009. 

I. Personal Data
Name:  Mr.  Ms.

______________________________________________________________________            Last                                         First                                                    Middle 

Home Address: 

______________________________________________________________________            Street Number                      City                 State                           Zip 

Home Mailing address if different from above:

______________________________________________________________________            Street Number                      City                 State                           Zip   

Cell Phone _______________ Business Phone _____________ Home ___________ 

E-mail_________________________________________________________________

Business Mailing address if different from above: 

______________________________________________________________________            Street Number                      City                 State                           Zip

Preferred location to receive mail?___________________________________
Preferred method of communication?____Cell phone_____text message on phone
_____e-mail_____Land line business_____land line home

Other personal information you wish to share:










II. Education 

III. Employment  

A. Current position and tenure







B. Previous occupation







IV. Personal References

Name at least 2 persons in this community whom the selection committee may contact for additional information about you.  Please list their name, business, title, address, phone, and e-mail address.

1.

2.

Letters of recommendation may be attached.


V. Community involvement/volunteer activities

1. Please describe your depth of involvement in community organizations.  List the number of years you’ve been involved in each organization.  Discuss your roles and responsibilities in each organization.

VI. General

A. What do you hope to gain from your involvement in Leadership Kaufman County?

B. In your judgment, what are 3 pressing challenges facing our community today?

________________________________                    ________________________________             Applicant’s Signature                                          Employer’s Signature  

*PLEASE BE REMINDED THAT THE SELECTION PROCESS IS SUBJECTIVE IN NATURE. 

COMPLETE RESPONSES ARE OF GREAT ASSISTANCE TO THE SELECTION COMMITTEE.

Leadership Kaufman County
Class Membership Contract

  If selected…

• I will fully participate in Leadership Kaufman County.
• I will attend the third Thursday of each month October 2009 through June 2010 for a total of 9 classes.  I have the authorization of the management of my company/organization for full participation.  If I withdraw from Leadership Kaufman County anytime after October 15, 2009, I am still responsible for full payment of the class.
• I will arrive on time each day and be in attendance the full day.  
• I will attend meetings assigned as homework/preparation for Leadership classes.
• I will remit all fees to Leadership Kaufman County by September 15, 2009.
• If I am unable to comply with any of the above, I will notify Leadership Kaufman County as soon as possible and voluntarily withdraw from the program.

The above commitment statement and the information submitted with this application are true and correct to the best of my knowledge.

Signature ____________________________________________ Date_____________________

Note:  Leadership Kaufman County requires a $350 fee for a total of nine classes.  If a participant is not able to complete the program, the fee is non-refundable.  A tentative schedule of activities is included with this application for review by prospective applicants.

One of the classes - State Government is held in Austin.  Registration fees for the Austin event are covered in the class fee.  However, transportation and lodging will be the responsibility of the student.