Shore Leadership 2.0 Class of 2022 Apply - Shore Leadership 2.0 Class of 2022 Apply to become part of the Class of 2022 12345 IntroductionPrefixMs.Mrs.Mr.Dr.First Name* Middle Initial Last Name* Nickname Years in MarylandYears on the ShoreEmploymentEmployer Number of EmployeesTitle Employed Since Shore Leadership Class of: Are you currently a dues paying member of Shore Leadership?* Yes No Business Street Address Business City Business StateAKALARAZCACOCTDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYBusiness Zip Code Business PhoneExtention Email Type of Industry Briefly list your major responsibilities LocationHome Street Address* City* State*AKALARAZCACOCTDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYZip Code* Mobile Phone*Email (if different from above) County in which you work County in which you live Demographic InformationGender Male Female AgeRace/Ethnicity Military, LEO, or Civil Servant Yes No Describe This is not a competitive application. Please complete the following questions so we can target your leadership needs during the program. Please list any leadership courses or training you had since you graduated from Shore Leadership?How many years have you been in a leadership position?How many people do you currently supervise?Briefly tell us what you hope to gain from the Shore Leadership 2.0 experience?Are there any cross Eastern Shore issues that you would like for us to consider in planning the 2.0 sessions?LETTER OF RECOMMENDATION Please provide a letter of recommendation from your current employee, a business associate, or Shore area leader indicating why you will be an asset to the Shore Leadership 2.0 program.Delivery Method* Upload Recommendation Letter Mail or Email Recommendation Letter Upload fileAccepted file types: txt, Max. file size: 32 MB.The only valid file type for upload is txt.Mailing address: Administrator Coordinator Shore Leadership PO Box 517, Easton, MD 21601 Email address: info@shoreleadership.org ATTENDANCEThe Shore Leadership 2.0 Program consist of three separate experiences. The program components will be facilitated by Dr. Joe Thomas and/or Carol Graser. You must commit to attending all three sessions (a total of 4 days), in order to be accepted into the program. The dates and locations are listed below: August 23 Eastern Shore Higher Education from 8:00am - 4:30pm. September 27 & 28 a day trip to Tangier Island followed by overnight with a half day on the 28th. October 11 Caroline County December 7 Recognition and Celebration at the Class of 2022 Graduation Celebration Are you able to walk 1 to 2 miles at a regular pace?* Yes No There will be times when the class will need to walk to different activities. Are you able to walk 1 to 2 miles at a regular pace? *Checking “NO” will not prohibit you from being accepted into the Class. Dates Reserved* I have reserved 2022 program dates on my calendar. NOTIFICATION, TUITION AND FEESReceipt of your application will be acknowledged by email. Applicants will be notified of the Selection Committee’s decision by June 15, 2022. Costs include tuition of $750 and a non-refundable application fee of $150. The $150 fee, due at the time of application, may be paid online or by personal check, and represents your personal commitment to the program. Final payment is due by July 30, 2022.EARLY BIRD REGISTRATION: Save $50 if you register and pay the non-refundable application fee before June 15, 2022. I understand the vision and mission of the Shore Leadership 2.0 program and that completion of this application does not ensure my acceptance. If selected to participate, I will devote the time required. I also understand that the maximum number of participants for the class is 18.I understand the vision and mission of the Shore Leadership 2.0 program and that completion of this application does not ensure my acceptance. If selected to participate, I will devote the time required. I also understand that the maximum number of participants for the class is 18.Applicant's Signature Date MM slash DD slash YYYY Notification Email* Payment Method* Pay Online Pay By Check Register for Shore Leadership 2.0 Class of 2022 Price: Please mail your $150 application fee, payable to Shore Leadership, by July 1, 2022 to: Administrator Coordinator Shore Leadership PO Box 517, Easton, MD 21601 Email: shoreleadership@gmail.com You will be linking to another website not owned or operated by Shore Leadership. Shore Leadership is not responsible for the availability or content of this website. We encourage you to review their privacy and security policies which may differ from Shore Leadership. Questions? Please e-mail us at info@shoreleadership.com
