The Chamber Area | Org Name | Address - Morris County Chamber of Commerce

Leadership Morris
Program Application

Program Application

* Indicates required field

Name *

First

Last

Title *

Organization *

Business Address *

Line 1

Line 2

City

State

Zip Code

Country

Business Email *

Work Phone Number *

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Please list your educational background including degrees awarded, fields of study, professional institutes, training programs, etc. Include special honors or awards. *

Please list current and past employers, length of employment, and areas of responsibility *

List the major civic, business and professional activities in which you have participated during the past five years. For each activity indicate the nature of your participation, including any offices you have held. Also, list awards or any special recognition you have received. Community involvement is a key selection consideration. If you have not been involved in any civic, business or professional activities, please explain why. *

List the community organization (s), if any, which you currently serve on the Board of Directors or Board of Trustees. *

Briefly describe how you expect to utilize and what you hope to gain from your Leadership Morris experience. *

Please briefly identify and explain a particular issue, opportunity or problem you feel is crucial to the Morris County area. *

Email *

Home Phone Number *

Years in Morris County *

List no more than two people who have knowledge of your qualifications as a Leadership Morris participant. NOTE: The Leadership Morris Alumni Council may contact both individuals.

Name *

First

Last

Title *

Reference's Home or Business Address *

Line 1

Line 2

City

State

Zip Code

Country

Name *

First

Last

Title *

Reference's Home or Business Address *

Line 1

Line 2

City

State

Zip Code

Country

For the current tuition rate, please refer to the upcoming session announcement/schedule. Tuition is due in full within two weeks of acceptance or prior to the Opening Retreat, whichever comes first. Although responsibility for tuition rests with the participant, partial financial assistance may be available to a limited number of applicants. (Financial need is not considered in candidate selection.)

Please Choose an Option *

MCCC Membe rTuition Non-Member Tuition I need tuition assistance. (If checked, please explain and indicate the amount of assistance required.)

Comment *

Thank you for your interest! We will review your application and contact you regarding our decision.
(We will keep your application on file for one year.)

In submitting this application, I hereby declare: That I have read the above statements. That to the best of my knowledge and belief, the information I have given is true and accurate. That except for circumstances beyond my control, I will undertake to complete the program in its entirety. (Your typed out name will count as signature)

Name *

First

Last

Submit

Leadership Morris Program Application

Program Application

Leadership Morris
Program Application