Leadership Pasadena · Class of 2021 Application Form for Leadership Pasadena

Welcome to the Leadership Pasadena application process. Please tell us about yourself by completing these application forms. Receipt of your forms will be confirmed within one week of submission (if you have not heard from us by then, email us at info@leadershippasadena.org). We will contact you to set up an interview to talk about the program with you in person. You will be informed of the decision on your application in May or two weeks after your interview, whichever is later. A fee $500 for partial payment of your tuition will be required by August 1 to reserve your spot in the Class. This $500 is part of your tuition. The remainder of your tuition will be paid by April 1 of the following calendar year. You will be offered payment arrangements to meet your needs. (Note: Military veterans applying for this program have special tuition scholarship arrangements which will be discussed with each veteran in person.) Thank you for your interest in leading in Pasadena! PLEASE NOTE THERE ARE SEVERAL SEPARATE FORMS FOR YOU TO COMPLETE ONLINE. YOU MUST CLICK "SUBMIT" AFTER EACH FORM TO SUBMIT THAT FORM. IF YOU DO NOT CLICK "SUBMIT" AFTER EACH FORM, THE FORM(S) WILL NOT BE PROCESSED!

Name

*

First Name

Last Name

Email for Leadership Pasadena communications

*

Tell us where we should send your Leadership Pasadena emails

Phone to Call You about Leadership Pasadena activities

*

Please give us your preferred phone number--cell, home, work.

This phone number is my:

*

Address to Send All Leadership Pasadena Materials

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Please provide three (3) references: name, relationship, phone numbers and email address

*

Please list one reference per line. Separate name, relationship, phone number and email address with a comma.

Employment Information

Information on your current employment, if any. Employment is NOT a requirement to participate in Leadership Pasadena and simply write NA in the all spaces. If you are a student, please list your school information in the next "SCHOOL" section.

Type of Employer

*

Organization/Employer

*

Company, City, School, Non-profit, etc Name. If you do not work outside of the home, please write NA

Position/Title

*

Years at Current Company

*

Total Years of Employment

If accepted, will you review the Leadership Pasadena schedule with your employer?

Since some Leadership Pasadena classes occur during the work week, we want to make sure you will be able to attend. If you are not currently employed, check NA.

Yes

No

N/A

I plan to in the future

Name of person you report to at work, if employed.

Your employer's support of your participation is important. We may want to contact your employer to invite them to your graduation or other event. If you are not employed, write NA.

Your Supervisor's Phone Number

Phone number of person you report to at work, if anyone. If you are not employed or you are self-employed or the CEO, write NA.

Please attach your resume or bio

Share your current bio or resume here

School Information

If you are a student, please tell us about your school and your course of studies.

School

Name of school at which you are taking classes

Degree being pursued

Please tell us what degree you are currently working towards--AA, Bachelors, Masters, Doctorate. Also tell us what is your course of study.

Name of person at school you work most closely with and phone number

Military Experience

Please tell us about your military experience.

Military Service

*

Are you a military service veteran or in active military service?

Yes

No

Please upload your DD Form 214 here

Only applicants with a honorable discharge will be considered for this program. If you received a discharge from military service that is less than honorable, please attach a brief written description of the reason for your discharge.Application materials are confidential and will be shared only with the small selection team.

Your Branch of Service and Last Rank

What was your most recent Military work experience (Branch of service, Unit, Rank, Dates, and Duties Performed.)

What was your previous Military work experience (Branch of service, Unit, Rank, Dates, and Duties Performed.)

How do you hope to use your Military experience and skills in civilian leadership roles in the community or in business?

*

In 100 words or less, how do you plan to serve the civilian community using your military experience and skills?

Non-Profit or Professional Activities

Information on your volunteer or professional activities in your community. Current involvement is NOT a requirement to participate. If you are involved in activities, however, we would like to know. If you are not currently involved in any such activities, simply write NA.

Current Volunteer Involvement

*

Please list the organizations you currently volunteer for. One organization per line.

Current Non-Profit or Professional Board Positions

*

Please list the names of any organizations whose Board you serve on. One organization per line.

Personal Interests/Concerns about the Greater Pasadena Area

Why are you interested in Leadership Pasadena?

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In 100 words or less, tell us why you are interested in the Leadership Pasadena experience.

What issue or issues confronting the greater Pasadena area most concern you; do you have ideas on how the issue(s) could be addressed and what role you would like to play (if any) in the solution.

*

In 250 words or less, share your community concerns with us and your ideas on solutions. You do NOT have to have solutions! Sharing your concerns will be just fine!

Describe one life experience that had a significant effect on your personal development (requested but if you do not wish to share just write NA).

*

What skills and talents will you bring to Leadership Pasadena?

*

In 100 words or less, describe the skills and talents you will bring to the program.

What do you hope to gain from your Leadership Pasadena experience?

*

In 250 words or less, explain any leadership skills you wish to develop; community knowledge or insights you hope to gain; benefits you hope to get for your employer, business or volunteer organization.

What other leadership development programs, if any, have you completed?

*

What other community development or communication education programs, if any, have you completed?

*

Have you reviewed the class schedule and, if accepted, do you have the necessary time?

*

Yes

No

Maybe

Do you wish to apply for financial aid to cover the cost of the Leadership Pasadena course

*

Apply for financial aid does NOT affect your application in any way. We do not want program cost to limit anyone's participation! If accepted, you will be sent a scholarship application at that time to complete. (Note: military service veterans, please select "Wish to apply for the Veterans Scholarship.)

Yes

No

Do not know yet

Wish to apply for the Veterans Scholarship

How did you hear about Leadership Pasadena?

Acknowledgements

*

In order to accomplish Leadership Pasadena’s objectives, the full participation of each individual is essential. Participants are required to attend at least 80 percent of all scheduled seminars in order to graduate. It is encouraged that each participant continue his/her involvement with Leadership Pasadena in some volunteer role after graduation. By typing my name below, I understand and agree to adhere to the required time commitment for Leadership Pasadena.

Name

First Name

Last Name

Another Acknowledgement....

*

You must pay $500 of your tuition by August 1. We encourage full payment of your tuition as soon as possible but we will establish an individual tuition payment plan with whomever is responsible for paying the tuition over time if needed. Tuition must be paid in full by April 1, 2021 in order to graduate. Tuition may be paid by check or credit card. By typing my name below, you understand and agree to the required financial commitment for Leadership Pasadena

Name

First Name

Last Name

Financial Responsibility

*

Who do you expect will be paying the Leadership Pasadena tuition?

I intend to accept full responsibility as an individual candidate to pay the full tuition by September 30 unless other arrangements are agreed to in writing by Leadership Pasadena (such as a financial scholarship and/or a payment plan.)

I intend that my organization or another sponsor will accept full responsibility for paying tuition by September, unless other arrangements are agreed to in writing, and I will have the full backing of my supervisor and organization for the financial commitment.

I intend to apply for the Veterans Scholarship to cover my tuition.

I am not sure yet who will be responsible for payment of the tuition. I am working on it!

Important Other Information

The following information is requested to help us evaluate our program. None of your answers will be used in considering your application to participate in the next Leadership Pasadena class.

How long have you lived or worked in the Pasadena area?

*

How well do you feel you know the Pasadena community?

*

How many hours per week do you currently volunteer for an organization?

*

How many organizations do you currently volunteer with?

*

How many organization Board of Directors are you currently on?

*

Your Age Range

*

Under 25

25-30

31-35

36-40

41-50

51-60

60+

Do you describe yourself as

*

Thank you!

Thank you for your interest in Leadership Pasadena. We will confirm receipt of your application within one week. We will contact you to set up an interview to meet several of our Board members and alums to discuss Leadership Pasadena with you in person. Interviews will be held March-May.

If you have any questions, please call Cindy at 818-606-5809 or email info@leadershippasadena.org

PLEASE CLICK ON THE SUBMIT BUTTON BELOW OR YOUR APPLICATION WILL NOT BE PROCESSED