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Program Application
PERSONAL CONTACT INFORMATION
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First Name
Last Name
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This is the email LCC will use for all communication, unless otherwise requested.
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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EMPLOYER CONTACT INFORMATION




Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code


First Name
Last Name

PROFESSIONAL DEVELOPMENT
Please list below your most recent employment or professional development, for the last 3 years. Or upload your most recent resume. Please include title/responsibilities and for how long you held each role. If not applicable, please skip to next section.


ORGANIZATIONS/ACTIVITIES
List the civic, business, professional, volunteer, and/or community activities in which you have participated during the past three years. Indicate for each activity the nature of your participation including any offices that you have held. List any awards or special recognition received.
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Applications are subject to evaluation and verification based on the information provided herein. I hereby authorize my current and former employers and educational institutions to release to Leadership Clark County any information regarding my employment and/or education which may help in selecting program participants.
PERSONAL STATEMENT
Your application will not be processed unless it is accompanied by a personal statement. You may either upload your statement or type it below. Please keep your statement concise, limited to 300 words, and answer only ONE of these two questions. 1) What area(s) of community involvement are you interested? 2) What achievement or activity has been the most important to you from a leadership or community perspective, and why?


REFERENCES
Please provide the contact information for two community members that have known you for one year or longer.
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First Name
Last Name
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First Name
Last Name
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ACKNOWLEDGEMENT
It is with this application that I wish to apply for the upcoming class of Leadership Clark County. I acknowledge that the information included is accurate, that an application does not guarantee enrollment, that I will be asked to participate in an interview process, and that I will be given an Offer of Enrollment before accepting participation or any financial obligations.
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TUITION ASSISTANCE/SCHOLARSHIPS
THIS SECTION IS OPTIONAL AND IS NOT REQUIRED TO BE FILLED-OUT FOR COMPLETION OF THE APPLICATION. YOU MAY CHOOSE TO SKIP THIS SECTION.
Scholarships
Leadership Clark County (LCC) offers two different scholarships to assist individuals with the tuition of the LCC program. In order to be considered for a scholarship award, candidates must meet all regular requirements for acceptance into the program by completing the program application and completing the scholarship application. Applicants can apply for one or both scholarships.
This scholarship exists to encourage and develop future leaders who are passionate about and contributing to the advancement of diversity, equity, inclusion and the elimination of racism.

LCC does not typically award full tuition scholarships. Most scholarship awards range from 20% to 50%.
Tuition assistance will be based upon the demonstration of financial need which otherwise would prevent participation in the Leadership Clark County Program.

LCC does not typically award full tuition assistance. Most assistance awarded ranges from 20% to 50%.



Payment plans are offered to all accepted applicants regardless of scholarships awarded. Payment plans must be negotiated prior to September 1st of the class year, will require a signed promissory note, and may be subject to convenience charges.