Program Application

Registration Information
Completed applications must be submitted to: Sumner County Leadership Initiative c/o Sumner County Economic Development, P.O. Box 279 or 314 N. Washington in Wellington. Applications may also be faxed to 620-326-6544
Contact Info
Occupation/Employement
Education/Training
(Include any prior Leadership Development Training)
School/Program Name/Location along with Degree/Certificate/Recognition Received
Community Involvement
List any community, school, professional, youth, religious, social, or other organizations in which your're participating or have participated.
Please list Organization, Number of Years, and Position or Committee
Personal Motivation and Commitment
The word "community" can apply to our cities, families, businesses, civic organizations, churches or any other place where people work and live together. Keeping this in mind, what do you feel has been your most significant contribution to a community, and why?
Why do you want to participate in Sumner County Leadership Initiative?
How do you plan to use what you learn in Sumner County Leadership?
Sumner County Leadership Initiative Program Commitment
Applicants for Sumner County Leadership Initiative must understand, and the program requires a serious commitment on their part. The program consists of one two-day overnight session and 8 class sessions. Attendance to ALL sessions is expected. The board understands emergencies arise and will work with participants in those cases, at the request of the participant. Any unexcused absence may be grounds for dismissal from the program. Tuition refunds will not be offered. Instead, the participant will be offered enrollment into the next year's program
Applicants who are employed are strongly encouraged to obtain their supervisor's permission (if applicable) to participate in Sumner County Leadership Initiative. Supervisors should have a clear understanding of the time commitment involved for participants.
Participants who successfully complete the program will be publicly recognized and receive a certificate.
Program tuition is $175 per person and must be paid to Sumner County Leadership Initiative prior to the Program Kickoff on the second Wednesday of September.
I understand the commitment required for active and successful participation in Sumner County Leadership Initiative and agree to them as stated above.
By typing my name and date, I understand this will act as my signature of commitment.
Applicant Employer or Supervisor (if applicable)
Name of Supervisor
Business and Position/Title
By signing my name and date, I understand this will act as my signature for this application.