Leadership New Albany Class of 2025 Application First Name * Last Name * Title * Employer Name * Employer Address Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Supervisor Name Supervisor E-mail Home Address Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Work E-mail * Work Phone * Personal E-mail * Cell Phone * The ideal Leadership New Albany participant is a mid- to high-level leader with a significant career trajectory and achievements. Briefly describe your past and current leadership roles. * Are you responsible for building and motivating a team, company, or business unit, including tasks such as hiring, coaching, and inspiring others? How many direct reports do you currently manage? * Your professional and personal growth as a leader, your level of community involvement, and the honors and awards you have received all play a role in the selection process. Please list and describe your community engagement and activities. * Why do you want to attend Leadership New Albany? * To ensure that all participants benefit completely from the Leadership New Albany program, full attendance is required. By selecting yes, I commit to attending all sessions. My employer and I understand that missing more than one session will result in not graduating, and the tuition is non-refundable. * Yes No 2025 sessions will be 1/15/25, 2/12/25, 3/12/25, 4/16/25, 5/14/25, 6/18/25, 7/16/25, & 8/13/25. Should I be accepted to the Class of 2025, I understand my company must be a Chamber member in good standing and the $1,000 tuition will be due by January 3, 2025. * Yes No Please list any food allergies or restrictions. T-shirt size (XS, S, M, L, XL, 2XL) * Upload File * Upload a professional headshot that will be used for class announcements, social media posts, and other promotional materials. Upload File Upload resume or any relevant documents (optional).
