Apply Online - Leadership New Hampshire

LNH Application 2010-2011

Through the application process, we want to get to know you, your ideas, and your vision to improve your community and New Hampshire. We request that your application be submitted by March 15, 2010 in order to be considered for the 2010-2011 class.

NOTE: We recommend that you save your work in Microsoft Word and cut and paste any essay answers to this application to avoid the loss of any work.

SECTION I: Personal Information

Full Name (include MI):

Nickname:

Email:

Where do you prefer to receive snail mail?

Home
Work

Home Address:
(Street, City, Zip Code)

You reside in which County?

Belknap
Cheshire
Grafton
Merrimack
Strafford

Carroll
Coos
Hillsborough
Rockingham
Sullivan

Phone (Home):

Fax (Home):

Job Title:

Current Employer:

Length of time at Current Employer:

Employment Address:
(Street, City, Zip Code)

Phone (Work):

Fax (Work):

How were you informed of LNH?

Please list any other Leadership programs you may have completed (including location and graduation date):

Would you consider participating in the next LNH class (2011-2012) if space is not available this year?

Yes
No

SECTION II: Current Employment

Briefly describe your job responsibilities:

What do you consider to be your most significant contribution or achievement related to your work?

SECTION III: Prior Employment

Please list past employers, titles, and dates of employment:

SECTION IV: Education

Please list your educational background.

SECTION V: Civic Involvement

Please list, in order of importance to you: civic, religious, political, professional, social and other activities:

Why did you become involved with the organizations that you feel are the most important to you? What have you learned from your involvement? NOTE: If you haven't been previously involved in community life, what has changed to allow more involvement now?

SECTION VI: Short Essay

What do you think are the three most important issues impacting New Hampshire and why?
(200 words or less)

SECTION VII: References

Please list the names, addresses, e-mail and phone numbers of your two (2) references (please make sure that one is from your present employer, if applicable). Choose individuals who are knowledgeable about your leadership potential and performance.

Both reference letters MUST be received by the March 15, 2010 deadline. No application will be considered complete until these are received. Please have these two letters of recommendation sent directly to the LNH office at: Two Delta Drive, Concord NH 03301 or to info@leadershipnh.org.

SECTION VIII: Commitment to LNH

Please read the following section and each of its parts. You will be asked at the end to check that you will comply with each of these sections and that you understand and are in full agreement with them. Your application will not be considered complete until you have completed this section.

PROGRAM:
Leadership New Hampshire's sessions take place on weekdays from September through May. Program days run from 8AM ï¿½ 5 PM, with three "overnight" sessions. The Program begins with an evening reception in June and an overnight retreat in September. Participation in the September retreat is mandatory. Associates also have monthly Action Assignments throughout the year of approximately 2-6 hours each. Each program session require approximately 2-4 hours of selected readings. Associates are encouraged to outline their personal learning goals, and to track progress on these goals during the year.

To graduate, participants must attend at least 10 days in their entirety. Candidates should have the support and commitment of their employers. Due to space and insurance considerations, participants may not bring dependents to the program sessions.

TUITION: $3,750
Tuition covers lectures and meals associated with each program day, as well as the cost of overnight accommodations at the retreat. Additional costs include: required reading materials and lodging costs for the other "overnight" sessions. Applications are available for Financial Aid, upon request, after acceptance to the program is received.

A Contract for the Program will be included with each acceptance notification, which must be signed and returned to LNH as soon as possible. An initial payment is due by JULY 1, 2010. Final payment will be due by AUGUST 31.

Would you like to have Financial Aid forms mailed to you?
Yes (NOTE: Checking this box does not affect the consideration of your application on a merit basis. Financial Aid Applications will only be mailed out to accepted candidates. All Financial Aid forms must be completed and returned to LNH within two weeks after you receive them in order to be considered for Financial Aid. )

SELECTION:
Each class will consist of approximately 38 diverse Associates selected from a wide range of backgrounds. Teams of interviewers will meet with each applicant; all applicants will be reviewed by the selection committee and the names of those selected will then be submitted to the Leadership New Hampshire Board of Trustees for approval. Notification of acceptance will be sent by the end of May.

Please read the Policies & Procedures and Program Dates - Remember to check your schedule for any clashes with the the program dates!

I have read and understand the purposes of LNH. I understand the commitment to Leadership New Hampshire. If selected, I will devote the time to complete the Program. I have the cooperation of my employer and/or all parties involved with me for completing this course.

You will receive instructions on how to pay your $35 Application Fee on the submission page when your Application is submitted.

In order for your application to be considered, this box MUST be checked:

Yes, I understand the expectations and am fully able to participate in LNH.