Apply Apply to become part of the Class of 2021 1 2 3 4 IntroductionPrefixMs.Mrs.Mr.Dr.First Name*Middle InitialLast Name*NicknameYears in MarylandYears on the ShoreEmploymentEmployer*Number of EmployeesTitle*Employed SinceBusiness Street Address*Business City*Business State*AKALARAZCACOCTDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYBusiness Zip Code*Business PhoneExtentionEmail Type of IndustryBriefly describe your responsibilities LocationHome Street Address*City*State*AKALARAZCACOCTDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYZip Code*Mobile Phone*Email (if different from above) County in which you work*County in which you live*State Legislative District (Work)State Legislative District (Home)Congressional District (Work)Congressional District (Home)Demographic InformationGender*MaleFemaleAgeRace/EthnicityMilitary, LEO, or Civil Servant*YesNoDescribe Have you participated in any other leadership program(s)?YesNoPlease list the program(s) and years(s) graduatedWhat do you consider your highest responsibility, skill, or career achievement to date?What do you hope to gain from the Shore Leadership experience?In your judgment, what are the two most pressing problems facing the Eastern Shore today? Explain why and any recommendation you may have for approaching and solving these problems.LETTER OF RECOMMENDATION Please provide a letter of recommendation from your current employee, a business associate, or Shore area leader indicating why you will be an asset to the Shore Leadership program.Delivery Method*Upload Recommendation LetterMail or Email Recommendation LetterUpload fileAccepted file types: txt.The only valid file type for upload is txt.Mailing address: Administrative Coordinator Shore Leadership PO Box 517, Easton, MD 21601 Email address: firstname.lastname@example.org ATTENDANCEThe program will kick off with a two-day overnight retreat in Sept. 2021, and subsequent sessions will be held monthly from Oct. through May 2022 at locations throughout the Shore. The program concludes with a graduation dinner in May or June (TBD). In order to accomplish the objectives of Shore Leadership, the full participation of each class member is necessary. Participants who miss more than one full day (with partial absences accrued in two-hour segments, up to eight hours), for whatever reason, will be dismissed from the program. Participants are required to attend the orientation and graduation sessions. NOTE: If you are dismissed due to attendance, or if you are unable to attend the orientation retreat, your tuition is nonrefundable. If you have a conflict with the orientation retreat dates, please defer your application until next year.Please reserve the 2021 program dates on your calendar before applying: Wednesday & Thursday, Sept 15 & 16(overnight retreat) Wednesday, Oct 20 Wednesday, Nov 17 NO MEETING IN DEC Wednesday, Jan 19, 2022 Wednesday, Feb 16 Wednesday, March 16 Wednesday, Apr 20 & 21 Wednesday, May 18 Graduation TBD (May or June)Are you able to walk 1 to 2 miles at a regular pace?* YES NO There will be times when the class will need to walk to different activities. Are you able to walk 1 to 2 miles at a regular pace? *Checking “NO” will not prohibit you from being accepted into the Class. Dates Reserved* I have reserved 2021 program dates on my calendar. NOTIFICATION, TUITION AND FEESReceipt of your application will be acknowledged by email. Applicants will be notified of the Selection Committee’s decision by July 1, 2021. Costs include tuition of $2,700 and a non-refundable application fee of $150. The $150 fee, due at the time of application, may be paid online or by personal check, and represents your personal commitment to the program. Credit for Early Registration: Upon acceptance to the class of 2021, $200 will be credited toward the tuition if the application and fee are received by March 15, 2021. Tuition includes individual, overnight accommodations for the two-day orientation retreat, seven full-day sessions focusing on regional issues and/or leadership training and the graduation dinner. In addition to tuition, participants will be responsible for the cost of their overnight accommodations during the second overnight session (cost not to exceed $150). If accepted for the 2021 class, you will be billed for the tuition amount. Payment will be due in full by July 1, 2021. Limited tuition assistance and tuition installment plans are available to qualified applicants. If you require assistance, please complete the Tuition Assistance Application by the March 15, 2021 deadline. The Tuition Assistance Application may be requested via email to email@example.com.Due to the advanced costs involved with program participation, once an applicant has been accepted into the program and confirms their commitment to participate, all tuition and fees become non-refundable. Withdrawal from the program due to extreme circumstances (hospitalization, military duty, death, job conflict, or other extreme situations) can be appealed to the Board of Directors for a case-by-case review.I understand the vision and mission of the Shore Leadership program and that completion of this application does not ensure my acceptance. If selected to participate, I will devote the time required. Applicant's SignatureDate Notification Email* Payment Method*Pay OnlinePay By CheckRegister for Class of 2021 Price: $150.00 Please mail your $150 application fee, payable to Chesapeake Leadership Foundation, by June 1, 2021 to: Administrative Coordinator Shore Leadership PO Box 517, Easton, MD 21601 You will be linking to another website not owned or operated by Shore Leadership. Shore Leadership is not responsible for the availability or content of this website. We encourage you to review their privacy and security policies which may differ from Shore Leadership. Questions? Please e-mail us at firstname.lastname@example.org.