Please type or print legibly Referred by Date completed and

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Please type or print legibly
Referred by
P.O. Box 720122
McAllen, Texas 78504-0122
[email protected]
Date completed and submitted
Name
Last
Age
First
Male
Female
Middle or Maiden
Years working/living in McAllen
Home Address
Phone
Primary E-mail_
Cell Phone
Employer
Occupation
Address
Spouse
Phone
Last
First
Middle or Maiden
EMPLOYMENT:
Present Employer
Present Title & Responsibilities
How long have you held this title?
Date Began with Employer
EDUCATION:
Highest level of education completed (check one):
High school
Undergraduate
Graduate
Post Grad
Military
Other (Please List):
ORGANIZATIONS AND ACTIVITIES:
Please list (in order of importance to you) up to five communities, civic, professional, business, religious, social,
athletic, and other organizations which you are or have been a member.
Organization
Approximate Dates of
Membership
Highest Official Position
Held and/or Awards Received
1)
2)
3)
4)
5)
*Please use extra paper if necessary for the following questions:
What have you accomplished in these activities that you think is important?
Approximately how much time each month do you presently commit to community, civic, professional
and other organizations/activities?
Have you been as active in community, civic, professional, and other activities as you would like to be?
If not, what have been the major barriers to your becoming involved?
If you previously have not had time or interest to become actively involved, what conditions have
changed that now enable you to seek involvement in the community?
What do you consider your highest responsibility, skill or career achievement so far?
What do you hope to gain from your Leadership McAllen experience?
Why do you think you would make a good candidate for Leadership McAllen?
Is there anything else that you would like to share about yourself?
If selected for Leadership McAllen, polo shirt size:
What shirt size (S-2XL)?
Check One:
Men’s
Women’s
Name for class nametag
All applications are subject to confidential evaluation by Leadership McAllen Board Members.
All questions must be answered in full for the application to be considered.
All applications must be postmarked or received by June 30 of the current year. All applicants will be
notified of acceptance or non-acceptance by July 31. (Dates subject to change)
Applicant’s Signature
Date
Employer’s Signature
Date
Employer’s Name Printed
Please return to:
[email protected]
Leadership McAllen
P.O. Box 720122
McAllen, TX 78504-0122
LEADERSHIP MCALLEN
(Application Insert)
ELIGIBILITY REQUIREMENTS FOR PARTICIPANTS
All participants must have lived or worked in McAllen or its unincorporated extra territorial jurisdiction for (1) year prior to
September 1 of the current calendar year. Priority shall be given to applicants who have demonstrated leadership abilities. Those
persons who, at the time of the selection of the class, are elected public officials shall not be eligible. Two members of the same
immediate family cannot be participants in the same class. Prior non-acceptance of an applicant does not affect future consideration
for selection. Leadership McAllen is designed for emerging leaders of any age.
ATTENDANCE REQUIREMENTS
Attendance is mandatory at all meetings and events for all class participants. We must ask that participants and their employers
commit to the entire Leadership McAllen course from August through May. If you are unable to make such a commitment, it is not in
your best interest to apply at this time. Missing any scheduled class, at the retreat or during the year, will result in an automatic
dismissal from the program.
applicant’s initials.
This year’s mandatory schedule is as follows:
Reception – Applicants selected for the class will receive an invitation to the class reception to be held in August.
Retreat – Friday, September 11, 2015, 12:00 pm through Saturday, September 12, 2015, 3:00 pm
Location: Courtyard by Marriot, McAllen. Rooms will be made available for all participants.
Participants are required (mandatory) to attend and stay the night.
Regular monthly meetings
Second Tuesday of each month, October through April*, promptly at 4:00 pm through 10:00 pm,
location to be announced by e-mail the week before each meeting.
*December and March meetings are subject to change due to MISD scheduling.
Graduation Ceremony
May 10, 2016. Time and location be announced.
TUITION AND FUNDING
All participants will be charged a tuition fee of $500 to cover meals, hotel, and transportation costs for the annual program. This fee
will be due and payable by August 31st unless other arrangements have been made with the Executive Committee. Tuition only
partially funds this program; the remainder comes from private and corporate contributions.
Limited Scholarship funds are available for partial tuition payments through the Leadership McAllen Alumni Association. Requests for
Scholarships and/or more information must be made in writing by June 30th. Send to [email protected] or Leadership
McAllen, P.O. Box 720122, McAllen, TX 78504-0122.
APPLICATIONS
Applications must be received by June 30th of the current year. Applicants will be notified of acceptance or non-acceptance by July 31st.
Applications must include the signed application insert.
Upon accepting enrollment with Leadership McAllen (“LM”) and LM sponsored events and/or its affiliated activities, I agree to abide by
the rules of LM Bylaws and any instruction provided. I understand and appreciate that participation in the class requires travel, tours,
mobile class instructions, communal dinners, which may all carry a risk to me of injury, including but not limited to traffic accidents,
premises injury, wildlife hazards, and food borne illness. I voluntarily and knowingly recognize, accept and assume the risk and release
LM, their sponsors, event organizers, and officials from any liability. I furthermore hold them free and harmless from any loss, damage,
liability, cost or expense during or caused in any way by my participation in LM. I understand all of the above and hereby submit my
application for Leadership McAllen.
Applicant’s Signature
Date
Employer’s Signature
Date
Employer’s Name Printed