16/50 Women’s Municipal Leadership Program Application

- Step 1 of 4

First Name *

Last Name *

Title *

Municpality/Firm/Organization/School *

Personal Email Address *

Work Email Address

Home Mailing Address *

City/State/Zip *

Phone Number *

Describe your previous and current involvement in local government (either professional or civic). *

Describe your personal goals, including why you are interested in becoming a city/village/township chief executive. *

Briefly discuss highlights of recent leadership responsibilities and achievements: what was/were the greatest challenge(s) and what steps did you take to overcome it/them? *

What outcomes do you hope for as a result of your participation in this program? *

What kind of community do you envision yourself serving in as a local government executive? (size of community, geographical region, etc) *

How did you hear about the 16/50 Project & the Women's Municipal Leadership Program? *

If selected, I understand that I am expected to attend all sessions of the program and I am available to do so. I understand that if I do not attend all sessions, I may not graduate from the program. *

Please attach your current resume in PDF format. *

Optional: please use this section to attach or paste additional information or recommendations you wish the application review panel to consider.

File Upload (PDF files only)

Applications must be received by June 8, 2019 to be considered. Chosen applicants will be notified by early-July.