Leadership Giles App

Enrollment is limited to 20 individuals. Completed applications are due by August 8, 2025.

All applicants will be notified of acceptance or non-acceptance no later than 7 days prior to the first class date.

Personal Data

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Email *

Cell Phone *

Business Phone *

Employment

(May attach resume and/or additional page(s), if preferred)

Present Employer *

Title *

Since *

Previous Employer *

Title *

Since *

Attach Resume

If preferred, not required. PDF or .doc file

Business & Professional Affiliations

Positions/assignment held and period of affiliation.

What do you consider your highest career achievement to date?

Community Involvement

Community Needs

In your opinion, what are three areas that could be improved in Giles County today? *

Explain your choices and give recommendations you have for approaching and resolving these problems.

What specific skills/knowledge do you hope to gain from the program if selected? *

Commitment

To successfully complete the Leadership Giles program, the participant must not miss more than two (2) classes to graduate from the program. Participants must attend all portions of a full-day session in order to graduate. Tuition is not refundable if the participant does not complete the program. * *

I am able to fulfill the commitment I am unable to fulfill time commitments.

By selecting I am able to commit above, I understand the purpose and commitment of the Leadership Giles program and if I become a participant, I will devote the required time.

Approving Manager Name & Title

Will you be requesting a partial scholarship due to financial hardship *

Yes No

Send Tuition Invoice To: *

Email or Physical Address

All applicants will be notified of acceptance or non-acceptance no later than 7 days prior to orientation.

Tuition must be paid in full prior to orientation.