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2009 Application
| Name: |
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Address: | | Address 2: |
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City: | | Zip: | |
E- Mail: |
| Home Phone:--
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| Occupation: | |
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| Length of residency in... |
| Colorado: |
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Evergreen: |
| List Past and Present
business, civic, community and volunteer activities in which you have participated: |
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| Provide two references
who can discuss your qualifications to participate in Leadership Evergreen: |
| Reference 1 |
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Reference 2 |
| Name: | |
Name: |
| Phone:-- | |
Phone-- |
| How are you acquainted: | | How are you acquainted: |
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Please identify and discuss one particular issue, opportunity or problem you feel is important
to the mountain community: |
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How do you hope the Leadership Evergreen program will help you fulfill your aspirations as a leader or
volunteer in the mountain community: |
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Tuition is $550. A few partial scholarships are available. Please check the box if you need
financial assistance to attend this program. |
Participants Agreement:
If accepted as a participant in the Leadership Evergreen program, I agree to the following:
During the program: attend all sessions ( More than two absences will delay graduation) and
participate in a class project. Following graduation: seek opportunities
to utilize leadership skills and abilities for the good of the mountain community; sustain and perpetuate
the Leadership Evergreen program.
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