Application

1190 Lewisburg Highway - FRANKLIN, TENNESSEE 37064 - (615) 794-0181

Please complete and return no later than June 30, 2011. Applications must be typed or printed in black ink. Thank you. (Please fill out as completely as possible as application form will be used in selection criteria process.)

Briefly describe your responsibilities                                                                                                                    

How long have you lived in Williamson County?                                                                                               

Have you been as active in community, civic, professional and other activities as you would like?
                                                                                                                                                                                         

If no, what have been the major barriers to your being involved?                                                                  

If you have not had the time to become involved, what conditions have changed that now allow you to
seek involvement?                                                                                                                                                        

Which of the following categories best describe your present area of leadership activity or interest?
(Check one)

Other                                                                                                                                                                                  

 

Please outline your academic background and training:

                                                                                                                                                          

                                                                                                                                                          

                                                                                                                                                          

                                                                                                                                                          

                                                                                                                                                          

Extracurricular activities and special honors awarded for leadership activities:

                                                                                                                                                          

                                                                                                                                                          

                                                                                                                                                          

Special awards, honors or prizes for academic performance:                                       

                                                                                                                                                          

                                                                                                                                                          

5.         PARTICIPATION

In order to accomplish our objectives, the full participation of each individual selected
is  necessary. Mandatory attendance is required for the sessions.

Will you be able to fulfill this commitment?                               

Do you have the support of your employer for the time required to participate in this
program? 

                                                                                                                                                          

 

Why should you be selected to participate?                                                                        

                                                                                                                                                          

                                                                                                                                                          

What do you hope to gain and how do you expect to utilize your Leadership
Franklin experience?

                                                                                                                                                          

                                                                                                                                                          

                                                                                                                                                          

                                                                                                                                                          

                                                                                                                                                          

6.         COMMUNITY ANALYSIS

Please identify a particular challenge, issue or problem you feel is critical to the
Franklin community. Explain your concern and possible involvement in the solution
of this issue:

                                                                                                                                                        

                                                                                                                                                           

                                                                                                                                                          

                                                                                                                                                          

                                                                                                                                                          

7.         TUITION
Tuition for Leadership Franklin is $500.00. If accepted into the program, tuition must be paid by August 14, 2011.

                                                                                                                                                          

Signature of applicant                                              Date of application