16/50 Women’s Municipal Leadership Program Application

First Name *

Last Name *

Which of the following best describes your race/ethnicity? Check all that apply. *

American Indian or Alaskan Native
Asian or Asian American
Black or African American
Latino or Hispanic
Native Hawaiian or Pacific Islander
White
Some other race (please specify below)
Prefer not to say

Add other:

Title/Position *

Municipality/Employer/School *

Personal Email Address *

Work Email Address

I prefer receiving email communications for the program: *

to my personal email address
to my work email address

Home Mailing Address *

City/State/Zip *

Work Phone Number *

Home/Cell Phone Number *

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Do you aspire to be a municipal manager (city, village, township or county manager/administrator)? *

Have you previously applied to the program? *

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/county manager: *

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? *

Describe the community you envision yourself serving in as a local government manager (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. *

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Please upload your current resume in PDF format only. *

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

Applications must be received by June 17, 2022 to be considered. Chosen applicants will be notified by early-July.