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PERSONAL CONTACT INFORMATION
This is the email LCC will use for all communication, unless otherwise requested.
Address Line 1
Address Line 2
EMPLOYER CONTACT INFORMATION
Employer's Mailing Address
Address Line 1
Address Line 2
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.
Upload Resume Here
Most Recent Professional Development or Employment
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.
Most Recent Organizations/Activities
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.
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?
Upload Personal Statement Here
Please provide the contact information for two community members that have known you for one year or longer.
Reference #1 Name
Reference #1 Email
Reference #1 Phone
Reference #2 Name
Reference #2 Email
Reference #2 Phone
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.
I accept all of the following:
I wish to apply for the upcoming class of Leadership Clark County
The information included in this application is accurate
This application does not guarantee enrollment
There will be a follow up interview process
I will receive an Offer of Enrollment before accepting participation or any financial obligations
THIS SECTION IS OPTIONAL AND IS NOT REQUIRED TO BE FILLED-OUT FOR COMPLETION OF THE APPLICATION. YOU MAY CHOOSE TO SKIP THIS SECTION.
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.
Leadership in Diversity, Equity, and Inclusion
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.
I'd like to apply for this scholarship
Scholarship Amount Requested
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.
I'd like to apply for financial assistance
Amount of Financial Assistance Requested
LCC does not typically award full tuition assistance. Most assistance awarded ranges from 20% to 50%.
What amount are you able to personally contribute toward tuition, if any?
What amount is your employer/other able to contribute toward tuition, if any? Copy
I acknowledge all of the following:
Program acceptance does not guarantee a scholarship will be awarded
Any scholarships awarded will be subject to a scholarship agreement
Please upload any statements, documents, or resources that you feel may be helpful in evaluating your scholarship or tuition assistance request.
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.
I'd like to request a payment plan