Organizations and Activities:
List memberships in community, civic, professional, business, religious, social, athletics, and other organizations (in order of value to you) during the past five years. If not applicable, leave blank.
How many hours per month are you currently committed to community, civic,
professional, and other organizations and activities? *
What do you hope to gain from your involvement in the Lonoke County Leadership Training Program? *
In your judgment, what are the three most important issues facing our county today? Give any recommendations for dealing with these issues.
Are you a registered voter?
If no, why not?
What other things should the selection committee know about you to make a decision about your application for the Lonoke County Leadership Training Program?
Name two persons in your community, not related to you, whom the selection committee could contact for additional information about you.
Do you have the full support of your employer for the time required to participate effectively in Lonoke County Leadership Training Program?
Tell us something interesting/unique about yourself that most people don't know.
Please copy and paste an updated bio. Please only include 1 - 2 paragraphs.
Please provide the name and phone number of person who referred you to our program:
Enter the verification code exactly as shown, using capital and lowercase letters, in the multi-colored box
By clicking on the "Submit" button below, you are confirming that the information contained in this application is true and correct to the best of your knowledge.
If you have not been contacted within three business days after your submission please contact one of the Steering Committee members.
© 2016 Lonoke Leadership. All Rights Reserved.
Designed and hosted by FAB Graphics and Consulting