Leadership Geauga Heritage Program Application

2021 Heritage Program Application

This application will be used to select participants for the Heritage Program Class of 2021. Please review the Program calendar before submitting your application.

In addition to completing this application, please send a headshot photo via email to Pam@leadershipgeauga.org

Application

If you encounter any problems submitting this form, please contact Pam Carson at 216.538.3411 or email Pam@leadershipgeauga.org

  • If you are employed, enter your business address below—otherwise, skip to the "preferred email" field. You will be asked for your personal contact information later.
  • If you chose #1 or #2 above in the Employment Status section, please indicate your preferred title and company for publication on our website, in press releases, and in the graduate directory. This company name will also be used on your name tag when you attend Leadership Geauga events. In the case of those retired and now consulting, you might enter "President" for your job title, and "Jones Consulting" for your company.
  • Drop files here or
    Max. file size: 64 MB.
    • Max. file size: 64 MB.
    • Year is optional.
    • Interview

      Answers of 200 words or less per question are preferred.
    • What about Geauga County do you most appreciate and value?
    • What leadership book would you recommend that you enjoyed, or one that has helped shape your outlook as a leader?
    • What is your favorite leadership empowerment quote?
    • What has inspired or motivated you to become involved in your community?
    • What is your favorite leadership or diversity quote?
    • Commitment

    Tuition Payment Options

    Leadership Geauga Signature Adult Program Alumni: $350.00
    Non-Alumni Signature Adult Program: $400.00

    You may pay by check or here online.

    Questions?

     If you have any questions or concerns about your program experience, please reach out to us at Pam@leadershipgeauga.org.

     Leadership Geauga County
    103 South Street, Suite #1
    Chardon, OH 44024