Leadership Salina Application

Thank you for your interest in Leadership Salina! To be considered for this year's class, please complete the entire form below, and submit.
Chamber representatives will be contacting you when a decision has been made. Applications are due August 1.

* Indicates required field

Name *

First

Last

Name You Go By *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone *

Cell Phone *

21 years of age or older? *

Yes No

Number of Years Lived in Salina/Saline County? *

Number of Years worked in Saline County? *

Employment

Current Employer *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Current Title or Responsibility *

Email address and mailing
Communication with class members will be via email. List an email address you prefer to use and can access from both home and work.

Email *

Please answer the following questions

What do you hope to gain from the Leadership Salina experience? *

After this experience, how do you intend to get involved in the Salina community? What specific organizations (community, civic, professional, business, religious, social, and athletic, etc.) do you plan to get involved with? What organization are you currently involved with? *

In your judgment, what are three challenges or opportunities facing the Salina area today? What are your recommendations for approaching and resolving them? *

List other information you may wish to make available to be considered in the selection process. *

Tuition
The tuition fee is $500. A limited number of partial scholarships are available. If scholarship assistance is needed, please contact LaCrista Brightbill at the Chamber office, 827-9301 or lbrightbill@salinakansas.org.

Scholarship Needed: *

Yes No

Attendance
Leadership Salina class members are required to attend all sessions, including a one day session at the Kansas Leadership Center in Wichita. In addition to the sessions, participants will spend time outside the “formal sessions” to complete a class project. Any absence, regardless of reason, must be excused by the facilitators. Participants unable to attend all sessions may, at the discretion of the Chamber, be withdrawn from the program. In such cases, there will not be a tuition refund.

Session Dates
Session 1: Wednesday, August 14 (8:30am - 5:00pm)
Session 2: Wednesday, August 28 (8:30am - 5:00pm)
Session 3: Wednesday, September 11 (8:30am - 5:00pm)
Session 4: Wednesday, September 25 (8:30am - 5:00pm)
Kansas Leadership Center: Wednesday, October 9 (7:00am - 5:00pm)
Session 5: Wednesday, October 23 (8:30am - 5:00pm)
Session 6: Wednesday, November 6 (8:30am - 5:00pm)
Session 7: Wednesday, November 20 (8:30am - 5:00pm)
Graduation: Thursday, November 21 (5:30pm - 7:00pm)

If selected, I can devote the required time to the program: *

Yes No

Have you applied for the Leadership Salina program before? *

Yes No

If yes, what year(s)? *

I am aware of the time requirement for Leadership Salina and will attend all scheduled sessions

My employer has approved my absence from work as required by the Leadership Salina program.

If so, type your name below: *

Application Deadline: August 1, 2019

Submit