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LEADERSHIP HOLLYWOOD CLASS XXXIX APPLICATION

Applicant Information

Please enter personal information about the applicant for the Leadership Program.

Business Information

Please enter information about your business or the business sponsoring this applicant for the Leadership Program.

Emergency Contact Information

Please indicate an individual to contact in case of emergency.

Miscellaneous
Community

Please list community activities in which you are currently involved. Indicate any major role that you have had in these organizations.

Please provide a brief explanation of a key issue that you believe currently faces Hollywood and briefly offer a possible solution.

Employer Authorization

Employer has approved the submission of this application and the time and financial commitment required to participate in this program.

Applicant Acceptance

UPON ACCEPTANCE TO THE PROGRAM
I will commit to the appropriate dates and if I am accepted to the program, will attend kick off orientation sessions as well as all other regular scheduled sessions and the graduation ceremony in order to complete the program. I understand that any absence must be approved in advance. I also understand that the program tuition $895 for chamber members and $1,200 for non-members is due prior to the kick off day and I am responsible for any portion of the tuition not paid by my employer. Program tuition is non-refundable.

Education and Work Experience

Please email a resume that lists your educational background and employment history along with a professional headshot in .jpg format to programs@hollywoodchamber.org

DEADLINE TO APPLY IS SEPTEMBER 17, 2014