First Name
Last Name
Middle Initial
Date of Birth
Sex	Male Female

Home Address

Business Address

What is your job title?

How long have you been employed with your present company?

What are the responsibilities of your current position?

Please outline briefly your employment history (example, as contained in your curriculum vitae).

Where did you attend high school (name of school and city) and when did you graduate?

Where did you attend college (name of institution and its location) and when did you graduate?

What other formal training have you had (continuing education classes, etc.)?

Please list any educational accomplishments, honors and/or recognition.

Why would you like to participate in Leadership Cherokee?

I believe I can make the following contributions to Cherokee County:

Three priorities I would like to see addressed by the leaders of Cherokee County.

List below any additional information you would like considered for enrollment in the program.


Limited scholarship funds are available, based on need, and are considered only after candidate selection is made. Please indicate if you would require financial assistance.
Yes
No

All Leadership Cherokee participants must attend the opening session and may miss no more than one of the remaining sessions. Please indicate your acceptance of this commitment by checking the box.

Have you applied to Leadership Cherokee before?
Yes
No

Nominator and employer signature must follow this application.

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