LEADERSHIP TUOLUMNE COUNTY – LTC
Application Packet for the Class of 2017/2018
Thank you for your interest in Leadership Tuolumne County (LTC)! The mission statement of LTC is to provide
a community-wide effort to ensure a solid base of informed and effective leaders to meet and address the present
and future challenges which face Tuolumne County. The ten-month program (September through June) provides
an in-depth look at private enterprise, government agencies, organizations, and individuals that make decisions
affecting our county every day. This is accomplished through eight monthly topic days, which include Arts, Culture
and the Quality of Life, Health and Human Services, Business and the Economy, Government, Law and Justice,
Media and Communication, Environment and Land Use, and Education.
Individuals benefit from the LTC program in a number of ways, including: a comprehensive understanding of
important community issues and organizations, a chance to meet with community leaders, increased leadership
abilities, building a diverse network of informed colleagues and expanding contacts.
The application deadline August 4, 2017 for the program year beginning on September 2017.
After receipt of the applications, appropriate candidates will be invited to a 30-minute interview scheduled between
August 14 to 25, 2017. Notice of acceptance will take place in September.
For more information, please visit our website at www.tcchamber.com/LTC.
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COMMITMENT/ PARTICIPATION REQUIREMENTS:
ATTENDANCE: LTC is a group learning experience and requires a significant time commitment by each participant. To complete the program, a
participant is required to attend the opening orientation, the monthly day-long topic days, be involved in at least one community project decided by
your class, and attend the graduation. Two absences will be justification for being dropped from the program.
The 2017-2018 schedule is as follows:
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Orientation
Monthly Topic Days
Capstone Meeting
Graduation/Recognition Ceremony
September 2017
October 2017 through June 2018
June 2018
June 2018
REGISTRATION FEES:
Application received on or before June 30, 2017:
Application received after June 30, 2017:
$700.00
$750.00
Leadership Tuolumne County’s participant fee covers all costs, including orientation, graduation and meals. It is anticipated that many employers or
sponsoring agencies would help pay the fee for selected employees. Limited scholarships are available for special circumstances. Selected
candidates will be notified and invoiced. Full tuition must be paid by September 20, 2017.
Please keep this page for your records.
Tuolumne County Chamber of Commerce
LEADERSHIP TUOLUMNE COUNTY (LTC)
222 South Shepherd Street, Sonora, CA 95370
www.tcchamber.com Email: [email protected] Phone: (209) 532-4212
Facebook.com/LeadershipTuolumneCounty
Tuolumne County Chamber of Commerce
LEADERSHIP TUOLUMNE COUNTY (LTC)
Class of 2017/18 Confidential Application
222 South Shepherd Street, Sonora, CA 95370
www.tcchamber.com • [email protected] • (209) 532-4212
Facebook.com/LeadershipTuolumneCounty
INSTRUCTIONS:
Please complete the application, obtain employer support authorization and return to the Chamber by August 4, 2017.
CRITERIA FOR SELECTION:
Leadership Tuolumne County seeks individuals:
 who represent the diversity of the county without regard to race, gender, age, and residence as well as occupation, including,
but not limited to, corporate and small business, education, government, arts, health care, and the religious communities,
as well as social service, county, and other non-profit organizations.
 with the ability to set and maintain goals as demonstrated by significant career, personal and/or community achievement.
 who have a willingness to commit the time and energy necessary to participate in the program.
 with a record of commitment to the community through past and present community activities.
 who will utilize their leadership for the long-term benefit of Tuolumne County.
PERSONAL DATA
NAME
LAST
FIRST
MIDDLE
PREFERRED (FOR NAME TAG)
MAILING ADDRESS
STREET / CITY / STATE / ZIP
CELL
STREET / CITY / STATE / ZIP
TELEPHONE
EMAIL
PRESENT EMPLOYER
BUSINESS ADDRESS
EMPLOYMENT HISTORY: List previous three years of employment history, beginning with current or most recent employer.
EMPLOYER
TITLE / RESPONSIBILITY
ORGANIZATION INVOLVEMENT: Please list, in order of importance to you, up to five organizations of which you have been involved within the last
five years.
ORGANIZATION
TITLE / RESPONSIBILITY
DATES OF MEMBERSHIP
PROFESSIONAL AFFILIATIONS: List professional affiliations, including office, committee, or leadership positions.
QUESTIONS:
Why do you want to participate in Leadership Tuolumne County?
What does Leadership mean to you?
Note any accomplishments, awards or other recognitions of which you want us to be aware:
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SCHOLARSHIPS: A limited number of partial scholarships and payment plans may be available. If you require tuition assistance, please give your
circumstances:
EMPLOYER SUPPORT: Applicants for the LTC program must have the support and commitment of their sponsoring business or organization. The
signature of the applicant’s supervisor or authorizing agent is necessary as an indication of the support of your participation in the program.
BUSINESS / ORGANIZATION:
I
of
NAME
BUSINESS / ORGANIZATION
give my full support for the time and personal commitment required for the applicant to participate effectively in Leadership Tuolumne County.
SIGNATURE
TITLE
DATE
APPLICANT’S AGREEMENT:
As a participant in LTC, I am willing and able to attend all functions sponsored by the program, and I understand that attendance is
understand that if I fail to meet any part of the obligation of participating, I may be asked to withdraw from the program.
required. I
Waiver: I, intending to be legally bound, do hereby, for myself, my heirs, executors, and/or administrators, waive, release, and forever discharge any
and all rights and claims for damages I may have against LTC and the Tuolumne County Chamber of Commerce, and any and all employees,
representatives, agents and heirs for any and all injuries that may be suffered by me or en route to or from LTC functions.
LTC Graduates will be asked to continue to support and be involved in the LTC program for at least one year following graduation
APPLICANT SIGNATURE
DATE