Leadership Corvallis Application There will be 10 classes beginning in September. Each session will be held on the second Thursday of each month (except June, which will be the 1st Thursday) and begin at 9 a.m. and end by 5 p.m. Full participation is expected so please ensure you can attend all sessions. (The schedule is subject to change for holidays; a full class schedule will be sent upon acceptance.) At least 80 percent attendance is required for graduation. Tuition is $195. This application requires a $25 deposit and the $170 balance will be due upon acceptance into the class. For additional information related to the application process please contact us at recruit@leadershipcorvallis.com. Applicant Information: (Please submit your name the way you want it on your class name badge)Name(Required) First Middle Initial Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Email(Required) Applicant Information:(if self-employed or retired, please state that in the current employer section)How many years have you lived/worked in Corvallis?(Required) Current Employer(Required) Title/Position Work Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Work PhoneWork Email Billing Address(Required)WorkHomeEmail Correspondence Preference:(Required)WorkHomeApplication QuestionPlease keep your answer concise (recommended 1-2 paragraphs).Please share why you're interested in participating in the 21/22 Leadership Corvallis program(Required)PROGRAM COMMITMENTPlease read and check the box next to each line to indicate you have read and understand your commitment to the Leadership Corvallis program.Policies(Required)I have read and agree to abide by the Leadership Corvallis policies on substitutions, cancellations and refunds, tuition payment, and graduation. These are posted at leadershipcorvallis.com/program Agree(Required)Respect(Required)I will respect fellow class members, the class host and speakers by being on time, staying for the entire session and minimizing distractions such as use of my cell phone or tablet. Agree(Required)Attendance(Required)I commit to attending and completing all classes. If unable to attend a class I will notify the Program Host. If an emergency forces my absence, I understand I may be eligible to make up class sessions the next year in order to graduate depending on space availability. Agree(Required)Volunteer(Required)I understand that Leadership Corvallis is an all-volunteer organization that depends on the time and talent of alumni to maintain the program. I am willing to volunteer with Leadership Corvallis following my class session if my time and talent can further the mission of the organization. Agree(Required)Cancellation(Required)I understand that in the event of a class being cancelled due to circumstances beyond the control of Leadership Corvallis, the organization will make reasonable effort to make up the class and I will make reasonable effort to participate. Agree(Required)PasswordCreate a password so you can log back in to the Leadership Corvallis site when your application is approved. Leadership Corvallis Application Fee Price: Credit CardCard Details Cardholder Name Signature(Required)Sign with a mouse, stylus or your finger on a touch deviceToday's Date MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.