EMPLOYER/SPONSORAPPLICATION

Please complete the following application for the employee that you are sponsoring to attend Leadership Pioneer Valley.Please recognize that there are both time and financial commitments for participation in the program. You may submit your answers here, on a separate page or online at .

Name: ______

Title: ______

Organization/Company: ______

Address: ______

City, State, Zip: ______

Phone: ______E-mail: ______

Name of Participant Sponsoring: ______

1)Why are you sponsoring this person to participate in Leadership Pioneer Valley?What does your company/organization hope to gain?

2)What leadership skills do they already exhibit?Cite any examples of leadership.

3)Please cite any examples of their emotional maturity and ability to regulate themselves under unfamiliar or stressful situations.

COMMITMENTS FOR PARTICIPATION

This form must be filled out completely, signed by you, and attached to the sponsor application to warrant consideration.

Financial Commitment

Tuition is $3500– Tuition covers all class year expenses including:the overnight retreat, meals, program training and materials, trainers, transportation, commencement ceremony, and graduation dinner.The above tuition includes a suggested personal tuition of $300 paid by each individual participant to ensure their personal engagement.Employer tuition assistance is available to non-profits, small businesses, and public sector employees.Flexible payment plans are negotiable upon request for both employers and applicants. For information on financial assistance refer to the Financial Assistance Request form which must be submitted with this application.

Employer Tuition Portion: $______

Applicant Tuition Portion: $______

Financial Assistance Requested: $______(be sure to submit a completed tuition assistance application)

Total Tuition: $3,500

Full participation by each participant of Leadership Pioneer Valley is critical. Minimum requirements for graduation include:

  • Program Reception- Thursday, September 20, 2018, 5:30 - 8:00 p.m. (required attendance, no exceptions)
  • Opening Overnight Retreat- Monday & Tuesday, September 24-25, 2018 (required attendance, no exceptions)
  • Program Sessions- Fri., October 12, Fri. Oct. 26, Fri, November 16, Fri, December 15, Fri, January 11 (snow date 2/1) 2019, Fri., February 15 (snow date 2/22), Fri, March 15 (snow date 3/22), and Fri., April 12.
  • All sessions run 8:30am to 5:15 pm. 20% or 16 hours excused absences allowed.
  • Half-Day (Recommended but Optional): Fri., Nov. 30 (am) and Fri., Jan. 11 (am)
  • Commencement and group presentations- Wednesday, May 15 13 (3-6 pm).
  • Leadership Labs- To be scheduled by groups (full participation expected, approx. 2-10 hr/month, most meetings occur outside of office hours.)

It is vital that participants and employers understand and honor these commitments.If your organization or employee are unable to commit to this schedule, please do not apply at this time.Applications without your signature will not be accepted.

I, as an employer, understand and agree to these commitments.

______

Employer Signature Employer Name Employer Title

______

DateName of ApplicantSponsoring