Leadership Twin Cities Sample Application
This is the information you will need in order to complete the Leadership Twin Cities application. This is not an actual application. To complete the online application, please visit www.minneapolischamber.org/leadership and select the link to access the online application.
Contact Information Prefix First Name Last Name Email Phone (ie: 612-370-9100) Title Company Information Company Name Business Address City State Zip Code Supervisor's Name Supervisor's Title Supervisor's Phone (ie: 612-370-9100) Supervisor's Email Organization Type
Non-Profit
Public Sector/Government
Organization Size (Based on Full Time Employees)
0-10
11-74
75-250
251 +
Application Questions
Please answer the following five questions using the text areas provided. The boxes will expand to allow for longer responses if needed. 1. What do you do? Please tell us about your current job responsibilities and share a brief summary of past positions.
2. Please tell us about your educational background.
3. List up to three organizations (professional affiliations, civic, religious, athletic or social organizations) with which you are currently involved or have been involved with in recent years.
• List them in order of importance to you • Designate if you are still actively involved and if any official offices held. • If you are not currently involved with community activities, please describe past experiences and
where you might see yourself involved in the future.
4. Identify and discuss an issue that you feel is critical to the Minneapolis-Saint Paul region.
5. Why are you seeking admission to the Leadership Twin Cities program? What do you hope to gain from your experience?
Supervisor Support
It is important that Leadership Twin Cities participants have the support of their supervisor and employer. Some corporations have an internal process for selecting applicants from their organization. Applicants are encouraged to discuss the application process, program cost and time commitment with their employer prior to submitting an application. Have you discussed your application with your supervisor?
Yes
No If no, please explain. Have you previously applied for the Leadership Twin Cities program?
Yes
No If yes, when? How did you learn about Leadership Twin Cities?
Chamber email or newsletter
Chamber website
Social Media Post (Facebook/Linked In/Twitter)
Referred by a past or current participant
Referred by my supervisor or company representative
Other Name of person who referred you
If other, please explain.
Personal Information
The following information is optional but very helpful. The selection committee works to assemble a participant group that represents a cross-section of the community. Factors that may affect the final class selection include age, ethnicity, gender, geographic location, vocation, life experiences and industry sector. The information in this section is confidential and will not be made public. Home Address City State Zipcode Gender
Female
Male Ethnic Background
Caucasian Hispanic
African American Asian
American Indian Other
Age
Under 25 25-34
35-44 45-54
55-64 Over 65
Highest Level of Education
High school diploma or equivalent
Attended college and/or associates degree
College graduate
Masters program graduate
Ph.D. or professional degree