LEADERSHIP TUOLUMNE COUNTY – LTC

Application Packet for the Class of 2017/2018

Thank you for your interest in Leadership Tuolumne County (LTC)! The mission statement of LTC is to provide

a community-wide effort to ensure a solid base of informed and effective leaders to meet and address the present

and future challenges which face Tuolumne County. The ten-month program (September through June) provides

an in-depth look at private enterprise, government agencies, organizations, and individuals that make decisions

affecting our county every day. This is accomplished through eight monthly topic days, which include Arts, Culture and the Quality of Life, Health and Human Services, Business and the Economy, Government, Law and Justice, Media and Communication, Environment and Land Use, and Education.

Individuals benefit from the LTC program in a number of ways, including: a comprehensive understanding of important community issues and organizations, a chance to meet with community leaders, increased leadership

abilities, building a diverse network of informed colleagues and expanding contacts.

The application deadline August 4, 2017 for the program year beginning on September 2017.

After receipt of the applications, appropriate candidates will be invited to a 30-minute interview scheduled betweenAugust 14 to 25, 2017.Notice of acceptance will take place in September.

For more information, please visit our website at

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COMMITMENT/ PARTICIPATION REQUIREMENTS:

ATTENDANCE: LTC is a group learning experience and requires a significant time commitment by each participant. To complete the program, a participant is required to attend the opening orientation, the monthly day-long topic days, be involved in at least one community project decided by your class, and attend the graduation. Two absenceswill be justification for being dropped from the program.

The 2017-2018 schedule is as follows:

  • OrientationSeptember 2017
  • Monthly Topic DaysOctober 2017 through June 2018
  • Capstone MeetingJune 2018
  • Graduation/Recognition Ceremony June 2018

REGISTRATION FEES:

Application received on or before June30, 2017:$700.00

Application received afterJune 30, 2017:$750.00

Leadership Tuolumne County’s participant fee covers all costs, including orientation, graduation and meals. It is anticipated that many employers or sponsoring agencies would help pay the fee for selected employees. Limited scholarships are available for special circumstances. Selected candidates will be notified and invoiced. Full tuition must be paid by September 20, 2017.

Please keep this page for your records.

INSTRUCTIONS:

Please complete the application, obtain employer support authorization and returnto the Chamber by August 4, 2017.

CRITERIA FOR SELECTION:

Leadership Tuolumne County seeks individuals:

  • who represent the diversity of the county without regard to race, gender, age, and residence as well as occupation, including,

but not limited to, corporate and small business, education, government, arts, health care, and the religious communities,

as well as social service, county, and other non-profit organizations.

  • with the ability to set and maintain goals as demonstrated by significant career, personal and/or community achievement.
  • who have a willingness to commit the time and energy necessary to participate in the program.
  • with a record of commitment to the community through past and present community activities.
  • who will utilize their leadership for the long-term benefit of Tuolumne County.

PERSONAL DATA

NAME
LAST / FIRST / MIDDLE / PREFERRED (FOR NAME TAG)
MAILING ADDRESS
STREET / CITY / STATE / ZIP / CELL
EMAIL
PRESENT EMPLOYER
BUSINESS ADDRESS
STREET / CITY / STATE / ZIP / TELEPHONE

EMPLOYMENT HISTORY: List previous three years of employment history, beginning with current or most recent employer.

EMPLOYER / TITLE / RESPONSIBILITY

ORGANIZATION INVOLVEMENT:Please list, in order of importance to you, up to five organizations of which you have been involved within the last five years.

ORGANIZATION / TITLE / RESPONSIBILITY / DATES OF MEMBERSHIP

PROFESSIONAL AFFILIATIONS: List professional affiliations, including office, committee, or leadership positions.

QUESTIONS:

Why do you want to participate in Leadership Tuolumne County?
What does Leadership mean to you?
Note any accomplishments, awards or other recognitions of which you want us to be aware:

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SCHOLARSHIPS: A limited number of partial scholarships and payment plans may beavailable. If you require tuition assistance, please give your circumstances:

EMPLOYER SUPPORT: Applicants for the LTC program must have the support and commitment of their sponsoring business or organization. The signature of the applicant’s supervisor or authorizing agent is necessary as an indication of the support of your participation in the program.

BUSINESS / ORGANIZATION:

I / of
NAME / BUSINESS / ORGANIZATION
give my full support for the time and personal commitment required for the applicant to participate effectivelyin Leadership Tuolumne County.
SIGNATURE / TITLE / DATE

APPLICANT’S AGREEMENT:

As a participant in LTC, I am willing and able to attend all functions sponsored by the program, and I understand that attendance is required.I understand that if I fail to meet any part of the obligation of participating, I may be asked to withdraw from the program.

Waiver: I, intending to be legally bound, do hereby, for myself, my heirs, executors, and/or administrators, waive, release, and forever discharge any and all rights and claims for damages I may have against LTC and the Tuolumne County Chamber of Commerce, and any and all employees, representatives, agents and heirs for any and all injuries that may be suffered by me or en route to or from LTC functions.

LTC Graduates will be asked to continue to support and be involved in the LTC program for at least one year following graduation

APPLICANT SIGNATURE / DATE