Adult Signature Class 52 ApplicationInstructionsAs this is a competitive selection process, please do your best to answer the following questions thoroughly and thoughtfully. Name First Last Gender Identity(Required)MaleFemaleNon-BinaryEthnicity(Required)American IndianAlaska NativeAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhiteYour Birthdate(Required) MM slash DD slash YYYY Job Title(Required)Employer(Required)Cell Phone(Required)Personal Email (Please be aware that your personal email will be our primary point of contact. Be sure to check it regularly.)(Required) Number of Years in the South Bend-Mishawaka region(Required)Education and Specialized Training College(s) Attended(Required)How did you learn about the Leadership Program and why are you interested in participating?(Required)How do you see yourself working to strengthen our community in the next 5 years? 10 years?(Required)What has been your most satisfying community activity? Why?(Required)What makes you a compelling candidate and how will you contribute to the class?(Required)Letter of RecommendationOne letter of recommendation is required to complete your application. You can upload the letter as a PDF file here, or have the nominator send the recommendation to [email protected].FileAccepted file types: jpg, gif, png, pdf, Max. file size: 100 MB.Check if tuition assistance is needer for: Tuition Assistance for Small BusinessNoyesPlease indicate the amount of assistance you are requesting. Please note, we are unable to provide 100% assistance at this time.Please enter a number from 1 to 100.Please indicate the reason you are requesting assistance.Sponsoring IndividualSponsoring OrganizationToday's Date MM slash DD slash YYYY Signature Name Postion Name Postion Name Postion Name Postion Name Postion Name Postion Name Postion Name Postion
