2024 Executive Leadership Candidate Application

2024 Executive Leadership Candidate Application

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PART ONE: PROFESSIONAL/PERSONAL INFORMATION

NAME

Title

First Name *

Last Name *

Suffix

Occupation/Title *

Employer *

Employer Address

Address Line 1 *

Address Line 2

City *

State *

Zip/Postal Code *

Business Phone Number *

Personal Information

Address Line 1 *

Address Line 2

City *

State *

Zip/Postal Code *

Home Phone Number *

Cell Phone Number *

Home email *

Preferred "first and last name" to be used on name tag *

Please attach a current resume to include education and professional background *

PART TWO: GENERAL QUESTIONS

Why are you enrolling in the Executive Leadership Program? What do you hope to gain from this program? *

Please list/explain other leadership training that you have completed *

How did you learn about the Executive Leadership Program? *

Business Friend Leadership Dutchess Alumni Website Chamber event Other

PART THREE: EMPLOYER RECOMMENDATION FORM

(if you are a sole proprietor, or do not have an employer that you report to, please request a personal recommendation form in place of this form by emailing foundation@chamberfdn.org).

The Executive Leadership Program is designed for mid- to senior-level managers and entrepreneurs seeking advanced leadership, strategic planning and communications skills to move their careers and organizations forward. This program focuses on topics critical to the success of individuals in organizations of all kinds, including large and small for-profit companies, governmental agencies, healthcare, and not-for-profit organizations. The program is sponsored by The Chamber Foundation, Inc. A recommendation by the employer is a required part of the application process. Your responses will be kept strictly confidential.

The recommendation also includes a commitment by the employer that the employee will be released from work responsibilities for scheduled program sessions.

Please have your employer fill out the form from the website link below and return in a sealed envelope to The Chamber Foundation, Inc., One Civic Center Plaza, Suite 400, Poughkeepsie, NY 12601 on or before December 1, 2023

https://www.dcrcoc.org/executive-leadership-program
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