Signature Program Application

Username Password

View Cart

Home
About
Events
News
Programs
Apply
Info Sessions
Contact Us
Leaders Online
Store
Photos

Apply

Signature Program

Applying to the Signature Program

Leadership Arlington invites you to apply to the Signature Program Class of 2013! Thank you for your interest!

Clicking "Next" at the bottom of this page to proceed to the online application.

This form CANNOT be saved. We strongly suggest that you complete your application in a Word document (download here) and paste them into the form when you are ready to complete the application in its entirety.

You may e-mail a completed Word or PDF application to Liz Nohra, at lnohra@leadershiparlington.org.

Deadlines:

Early Bird Deadline: 12 noon on Monday, April 16, 2012. $50 Application Fee.
Final Deadline:12 noon on Tuesday, May 15, 2012. $100 Application Fee.

Application Process:
1. Complete the Online Application

After submitting the application, you will be taken to a page with links to the following forms:

2. Pay the Application Fee:

$50 until applications close at 12 noon on April 16, 2012.
After that, $100 until the final deadline at 12 noon on May 15, 2012.

To go directly to the Application Fee Payment Page, click here.
Checks may be mailed to:
Leadership Arlington
4420 N. Fairfax Drive, Suite 102
Arlington, VA 22203

3. Submit a Supervisor Statement of Support (required):

Each applicant is required to have their supervisor review and sign the statement of support in order for their application to be complete.
Those who are self-employed or are the chief executives of their organizations may submit an explanation.
Chief executives at nonprofit organizations are requested to submit a statement of support from their board chair.
To go directly to the Statement of Support Form, please click here.

4. Submit a Statement of Relevance (if applicable):

If an applicant does not live or work in Arlington County, they must submit a statement of relevance detailing why they are interested in Leadership Arlington's Signature Program.
To go directly to the Statement of Relevance Form, click here.

5. Submit a Scholarship Request (if applicable):

If the applicant desires a scholarship, they must complete the scholarship request form with the organization's operational budget.
All requests remain confidential.
All scholarship requests must be submitted with the application.
To go directly to the Scholarship Request Form, click here.

Application Checklist

Application Fee:

I agree to pay an application fee of $50 before 12 noon on Monday, April 16, 2012. After the application fee becomes $100 until the final deadline on May 15, 2012.
Pay the application fee online, or send a check to: Leadership Arlington | 4420 N. Fairfax Drive, Suite 102 | Arlington, VA 22203. You will be directed to the payment page when your application has been submitted.

Program Information, Qualifications, and Applicant Criteria: I have carefully read the Signature Program information page and understand that the program is a 10-month program. Click here to read about the Signature Program.

Attendance Policy: I have reviewed the calendar of program days and will miss no more than 2 program days throughout the course of the program. View program calendar for the Signature Program Class of 2013.

Mandatory Attendance at Opening Retreat: I understand that, if accepted, attendance at the opening retreat is mandatory. The opening retreat will take place on Thursday, September 13th and Friday, September 14th, 2012.

Tuition: I understand that, if accepted, tuition of $4250 will be due on August 1, 2012 unless other arrangements have been made with the President & CEO.

Statement of Commitment: I understand the mission of Leadership Arlington. If selected, I will devote the required time and pay my tuition by August 1, 2012. If I am unable to comply with the requirements, I will voluntarily withdraw from the program. I understand that, in the interest of the class experience for all participants, any participant may be removed from the class if, in the opinion of Leadership Arlington, that participant’s conduct is not conducive to the work of the group. I further understand that tuition is not refundable in whole or in part.

About You

First Name * Last Name * Middle Initial Name you prefer to be called:

Applicant Information

Date of Birth * Gender Male
Female
* Ethnicity

Contact Preference

Send Mail To: Home
Office
* Send Email To: Home
Office
*

Home Address

How long have you lived here?( In Years )

Street Address (Do Not Give PO Box) *

City State Zip

Home Phone Cell

Home Email Fax

Work Info

Employer * Street Address *

City State Zip

Website Work Phone Fax

Work Email How long have you worked here? ( In Years )

Describe the work of your organization (350 Characters Left)

What type of organization is your employer? Business Non Profit Government *

What is your current position in the organization?

How did you hear about Leadership Arlington?

Education and Training

Please list your education and training (beginning with the most recent):

Community Involvement

Please list your involvment in the community outside of your work (750 Characters Left)

Other Activities & Accomplishments

Please list your honors, activities, and accomplishments. (750 Characters Left)

Tell Us About Your Leadership

Please give an example of when you felt your leadership made a difference. (750 Characters Left)

Tell Us More About Your Community Involvment

What have you found to be your most challenging community involvement? Why? (750 Characters Left)

Your Contribution to Leadership Arlington

What do you believe you can offer to enhance your Leadership Arlington class? (750 Characters Left)

Your Expectations

What do you hope to gain from your experiance with the Leadership Arlington Signature Program? (750 Characters Left)

Your View of the County

Please list two pressing issues facing Arlington County

Issue 1. (750 Characters Left)

Issue 2. (750 Characters Left)

Additional Information

Is there anything else you'd like to share about yourself that you feel would be important for the selection committee to know during their decision-making process? (750 Characters Left)

Please type the letters and numbers as you see them (case sensitive):

Our Programs

Signature Program
Youth
Leadership Institute of Northern Virginia
Executive Forums
Young Professionals
Speaker Series
Faculty

Home | Events | Privacy Policy | Contact Us

4420 N. Fairfax Drive, Suite 102 Arlington, Virginia 22203
Tel: (703)528-2522 | Fax: (703)528-9552