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LEADERSHIP CLAY CENTER 2010

Registration

    

Participant Information

  Name:    
  Address:    
  City:      State:        Zip   
  Work Phone:    
  Cell Phone:    
  Email Address:    

 

  Previous Leadership training/experience:  
       

 

Employer Information

  Employer:    
  Title:    

 

  It is desirable that each participant in Leadership Clay Center 2010 have the support and commitment of their employer.   

 

 

(Participant's name)

has my full support to

 

  participate in Leadership Clay Center 2010.  I understand that attendance at each  
  scheduled class, tour, and project is required and expected to successfully complete  
  the program.  

 

  Employer's Initial:

Date:

 

 

Personal Commitment

  Yes No   I understand I must attend all class sessions, activities, tours, and the graduation celebration in order to complete the Leadership Center Program and I have reviewed the class schedule.  
           
  Yes No   I understand in case of an emergency only one absence will be excused.  Any unexcused absence will prevent program completion.  
           
  Yes No   I understand that I will be expected to spend some time outside the scheduled class sessions preparing for class projects.  
           
  Yes No   I understand participants will sponsor a class project to benefit the community, including the design and execution of the Class Project.  
           
  Yes No   Upon graduation, I plan to use my new leadership skills to benefit my community  

 

 

  Yes No   I understand that the tuition to participate in Leadership Clay Center 2010 is $100.00 and this fee will cover program materials, meals and trip expenses.
       

 

       

Please send payment to:

Clay Center Area Chamber of Commerce

517 Court Street

Clay Center, KS 67432

 

Payments are due by February 23, 2010.

         

 

 

 

The class roster will be announced to the media and participants on February 23, 2010.  The Class size will be limited to twelve participants to provide a quality learning experience.

 

 

 

 

 

 

 

 
 

 

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Last modified: 01/01/01