Leadership Program | United Way of the Brown County Area

Leadership Program

Bridging Brown County Leadership Program Application

Tuition fees for 2021-2022 is $400 for nine leadership days.

This includes all meals, refreshments, training and transportation.

Applications are due by July 31, 2021. The first session will be held on Thursday, September 23, 2021.

Our next cohort will begin September 2021.

First Name

Last Name

Home Address

City, State, Zip Code

Mobile Number

Work Number

Personal Email

Work Email Address

Years living/working in Brown County

Age

Ethnic Background

Gender

Please include organization and position held/responsibilities.

Employment Status:

Place of Employment

Employer Address

Do you need scholarship assistance to participate?

Leadership Program: Scholarship Request

City, State, Zip Code

My employer is willing to make available the necessary time for full participation in all scheduled sessions.

Other work experience/training

Why do you want to participate and what do you hope to gain from participating in the Bridging Brown County Leadership Program?

Signature

Date

Are you requesting a business scholarship or individual scholarship?

Is your organization/business a nonprofit?

If no, what type of business does your organization have?

How many employees does your organization have?

What is your organizations annual revenue?

Did your organization/business receive a Payroll Protection Loan in the past year?

Was your business closed or otherwise affected by any of the COVID-19 Pandemic State of Minnesota Mandates or Executive Orders?

If yes, explain how:

Amount of scholarship funds requested:

If awarded a half scholarship, are you or your employer able to cover the remaining program fee?

Do you have other funding sources if a scholarship is not awarded?

Payment plans are accepted. Is this something you would be interested in?

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