Upon filling out the application below, you will receive an email acknowledging receipt of your application. If you don't receive an email within 24 hours, please contact Leadership Reno County directly at info@leadrenocounty.org or 620-474-0263.

First Name*
Last Name*
Preferred Name
Home Address*
City*
Zip*
Preferred Phone*
Other Phone

Communication with class members will be via e-mail. Provide an e-mail address you prefer to use.

Email*
Number of Years Lived in Reno County*
Number of Years Worked in Reno County*

21 Years or over?*

Yes
No

Employment

Employer Name*
Employer Address*
Current Title or Responsibility*

Additional Information

1. What do you hope to gain from the Leadership Reno County experience?*
2. In your judgment, what are three challenges or opportunities facing Reno County today?*
3. List other information you may wish to make available to be considered in the selection process.

4. Leadership Reno County class members are required to attend all sessions. Any absence, regardless of reason, must be excused by one of the co-directors. Participants unable to attend all sessions may, at the discretion of the co-directors, be withdrawn from the program. In such cases, there will not be a tuition refund. If selected, I can devote the required time to the program.*

Yes
No

5. Have you ever been convicted of a person or sex crime of severity level 3 or higher or its equivalent?*

Yes
No

Scholarships

A limited number of partial and full scholarships are available. Is a scholarship needed*

Yes, full scholarship
Yes, partial scholarship
No

After clicking "Submit", please wait for your application to process. If you do not get a response in 24 hours, please contact us at info@leadrenocounty.org. Thank you for your submission!