2026 Leadership Monroe Application

Name

Title

First Name *

Last Name *

Suffix

Home Address

Address Line 1

Address Line 2

City

Zip/Postal Code

Employer, Job Title *

Work Address

Address Line 1

Address Line 2

City

Zip/Postal Code

Work Number *

Cell Number *

Work Email address *

Email address *

Birthdate

Format: MM/dd/yy

Gender

Male Female

What do you hope to gain from participating in Leadership Monroe? *

In your opinion, what are the three most pressing issues facing Monroe County today? *

Community Involvement

Please explain your involvement in three community activities- civic, business, religious, political, government or social in nature.

1. Organization *

Assignment/Position *

Years Involved *

Describe Responsibilities *

2. Organization *

Assignment/Positon *

Years Involved *

Describe Responsibilities *

3. Organization *

Assignment/Position *

Years Involved *

Describe Responsibilities *

Employment Record

List present position first.

1. Employer *

Job Title *

Period of Service *

2. Employer *

Job Title *

Period of Service *

3. Employer *

Job Title *

Period of Service *

Employment & Professional Affiliations

Which of the following best describes the company you are employed by? *

Large Business (>50 employees) Medium Business (26-49 employees) Small Business (<25 employees) Self Employed

Briefly describe your responsibilities in your current position. *

What do you consider your most significant contribution or achievement in your position thus far? *

Educational Background

For each of the following, please include degree awarded and year received along with name and location of institution.

High School *

Undergraduate *

Advanced Degree(s) *

List activities, offices and recognitions: *

Significant continuing education experiences: *

Commitment

If selected as a Leadership Monroe participant, I understand that I am committing myself to involvement in the community upon graduation from the program. My name and contact information will be published in Chamber materials for distribution to community organizations. Additionally, my name will be given to community service organizations that are seeking volunteers.

Applicant's Initials *

Attendance

The time commitment to Leadership Monroe is nine months. The program begins with an initial Meet & Greet on September 5, 5:30 - 7:30 pm in which you will receive your materials for the program. Our first class will be an OVERNIGHT Class Retreat (mandatory) on September 12 (8:30am start time) through 1:00 pm on September 13. The remaining classes, 7 monthly meetings (October - April) will fall on the 1st Thursday of each month with the exception of January (2nd Thursday), and concludes with a Graduation Dinner (May). ATTENDANCE AT ALL SESSIONS IS REQUIRED. Additionally, attendance of a County Commission, City Council, Board of Education meeting and Chamber event is required as well as participating in a community project. You are allowed to miss one session without consequence. If 2 classes are missed, you are ineligible for graduation until one of these is repeated during the following year's class. If more than 2 classes are missed, you are ineligible to graduate and must repeat the entire year (including repaying tuition) in order to be considered a graduate of the program.

Applicant's Initials *

I have full support of my employer for the time required to participate.

Employer's Initials *

Letter of Recommendation

A letter of recommendation is required from your employer. If you are self-employed, a letter will be accepted from a local business colleague or previous graduate of the Leadership Monroe program. The letter should explain how your background and experience would contribute to the leadership class and why you should be considered for the 2024 Leadership Monroe Program. Please email letters to president@forsyth-monroechamber.com

Upload photo

Please upload a recent photograph of yourself. If selected for the upcoming class, this will be utilized in marketing material for the program and possibly placed on the website for announcement of the Class.

Community Project

In addition to the sessions, you will be asked to commit your time to a community project. The amount of time you will need to devote to the development of the project will be determined by the consensus of the group. Participation in any group meetings is expected.

Tuition

Leadership Monroe tuition is $800.00. Chamber members receive a $100.00 discount. Tuition covers all program costs for each of the sessions, Opening Retreat, and Graduation Dinner. Tuition is non-refundable once the program begins. Please indicate your payment arrangements.

Is your business/employer a Chamber member?

Yes No

Tuition will be paid for by:

Self Employer

Payment will be made in:

Full Monthly ($200 first payment, must be made)

Date and Time

Format: M/d/yyyy

Signature

By typing your name in the box below, you are committing to and validating that all information provided is accurate and true.

Employer's Signature *

Applicant's Signature *

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