Chamber ApplicationCHAoMF BER
COMMERCE
Leadership
Meridian
Confidential Application
INSTRUCTIONS
Type or print in black ink. Please complete each section fully. Limit answers to the space
available. Application must be signed by both applicant and employer / sponsor and returned to
the Chamber of Commerce office.
SELECTION CRITERIA
Participation in L e a d e r s h i p M e r i d i a n is' open to persons living in the Meridian area.
Since the number of participants in L e a d e r s h i p M e r i d i a n is limited, applicants who are
not selected are encouraged to reapply in subsequent years.
Participants will be chosen by the L e a d e r s h i p M e r i d i a n Selection Committee based
upon the information completed on this application and a follow up interview. The Committee
will be seeking representation from a cross-section of the community. The leaders and potential
leaders will be active in business, education, the arts, religion, government and community
based organizations and will reflect the diversity of the community.
Applicants must have the full support of the organization or corporation they represent.
Attendance at retreats and monthly sessions is mandatory. Those who fail to attend may be
asked to withdraw with no refund of tuition.
Leadership
Meridian
A program of the Meridian Chamber of Commerce
Confidential Application
I. Personal Data
Date
Name
Nickname
Last
First
Middle
Male[ ] Female [ ]
Home Address
Number Street City
Business Address
Number
Home Phone
Street City
Business Phone
Zip Code
Zip Code
II. Education
(Include all degrees and any specialized training received)
Name & location of School
Dates (from-to)
Degree
Major
III.Employment
Present Employer
Type of Business
Title or Responsibility
List previous employment in reverse chronological order:
Date Hired
Since
IV. Community Involvement
Include community, civic, religious, political, government, social, athletic, or other activities.
Organization and Title
V. General Information
A. What do you feel are the three most significant problems facing Meridian today?
What do you feel needs to be done about one of these issues?
B. What are the three most notable oppommities the Meridian area has to offer?
What do you feel needs to be done to develop these opportunities?
VI. References
Please list individuals other than relatives who know of your qualification and/or background experience.
Name Profession Phone No Address
VII. Commitment
To graduate from L e a d e r s h i p M e r i d i a n, the participant is expected to attend all sessions.
One full weekday each month--September through May.
Active involvement in the planning of at least two sessions in the year following the class experience.
I understand the purposes of the L e a d e r s h i p M e r i d i a n, program and if I am selected I will devote the
time and resources necessary to complete the program. Even though emergencies do arise, any participant
missing more than 20% of the program, for whatever reason, may be asked to withdraw from the program and
no portion of the tuition shall be refunded. I understand the above commitments and agree to be bound by
them in signing this application.
Applicant Signature
Date
TUITION
If accepted into the program, you or your employer / sponsor will be billed for the tuition fee which covers all
program costs, including meals. Tuition is $585 for Chamber Members and $715 for Non-members, and must
be paid in full prior to the first session in September.
Will your employer pay the tuition fee? [ ] Yes [ ] No
Will you pay the tuition fee? [ ] Yes [ ] No
EMPLOYERS COMMITMENT
This application has the approval of this organization and the applicant has our full support which includes the
time required to participate in the program.
Firm
Signature Title
APPLICATIONS SHOULD BE MAILED TO:
Meridian Chamber of Commerce
Attention:' Leadership Meridian
PO Box 7
Meridian, ID 83680