Community Leadership School Application 2027

First Name *

Last Name *

Email *

Phone *

Please provide your direct cell phone number.

Title *

Organization

Address Line 1 *

Address Line 2

City

Supervisor's Name

Supervisor's Title *

Supervisor's Email Address *

Billing Contact Name *

Billing Contact Email

Volunteer Experiences

If applicable, please list up to two community organizations in which you demonstrate an active leadership role in a volunteer capacity beyond your professional affiliations and activities. 

Do you currently or have you served on any Board of Directors? *

Yes

No

Board Details: Please list the board(s) you serve or have served on.

What are the most important values you demonstrate as a leader? *

What are your expectations of the class? *

Is your organization aware you are applying for CLS and will they support your participation? *

Yes

No

Terms & Conditions *

Please review and check the box of all items to agree.

1. Applicants must have full cooperation and sponsorship from their employers and associations.

2. Applicants must possess the following: a) A demonstrated ability to achieve personal goals, b) A ready availability of time and resources to devote to community service, c) A personal commitment to the Greater Peoria area.

3. Participants are expected to: a) Attend all CLS weekly classes, b) Attend the orientation reception and graduation dinner, C) Participate in class projects, d) Attend as many field trips as possible.

4. Tuition: $1300 for Chamber Members or $2000 for Non-Chamber Members *(Please do not send payment with application - Payment options and instructions will be shared with selected applicants.)

Authorization *

Type your full name in the box below to confirm that you have reviewed and understand the mission, program requirements, selection process, and participants' commitment to the Peoria Area Chamber of Commerce Community Leadership School. If selected, I will devote the required time and pay my full tuition before the program orientation session. If I am unable to comply with the requirements, I will voluntarily withdraw from the program. I understand that in the best interest of the class experiences for all participants, and participants may be removed from the class if, in the opinion of the Community Leadership School Steering Committee, a participant's conduct is not conducive to the work of the group. I further understand that tuition is non-refundable.

Date of Application Submission *