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Events
- Upcoming Events
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Program Areas
About

Apply to Leadership Upper Valley

Important Dates for 2023-24
June 30	Application Deadline
July 14	Decision Notification
July 14	Scholarship Awards Announced
Aug 14	Tuition Due
Sept 13	First Session

Tuition for the 2023-24 session is $1,650. Scholarships are available.

In This Section

Leadership

Application Form

Your Full Name

Your nickname, if you use one

Your preferred pronouns

Email

Where do you receive mail - home or work?

Home

Work

Home address

Street Address City State / Province / Region ZIP / Postal Code

Home phone

OPTIONAL: Please share some demographic information

Age

18-30 years old

30-45 years old

45+

Prefer not to say

Gender

Ethnicity

Asian or Pacific Islander

Black or African American

Native American

White or Caucasian

Multi-ethnic or Biracial

Prefer not to say

How did you find out about Leadership Upper Valley?

Your current employer and role, if applicable

Work Address

Street Address City State / Province / Region ZIP / Postal Code

Work phone

Briefly describe your job responsibilities

Tell us about a contribution that you're proud to have made in your work or in your community. What motivated you to make this contribution?

Why do you want to participate in Leadership Upper Valley? What do you hope to learn from your peers and what contributions will you make to the learning community?

Leadership Upper Valley requires a commitment to be present for 10 day-long sessions, with a couple of hours of preparation for each session. Please acknowledge that you are prepared to fulfill those responsibilities.

Yes

No

We seek a rich group dynamic. How would your life experience add to the diversity of perspectives in our group?

What are the three most important issues for you that impact the Upper Valley and why?

Applications will be considered complete once we receive your application as well as a reference letter. These letters can be an informal email -- aim for substance, not formality! Please ask your reference to send the email to John Drew (jdrew@vitalcommunities.org).

I understand that the cost of the program is $1,650. Tuition is due in full upon acceptance to the program. Tuition is non-transferable and non-refundable. We are continuously seeking ways to reduce barriers to participation. We have limited grants available - please reach out to John Drew @ jdrew@vitalcommunities.org for more information. Admission decisions are made separately from any information shared regarding tuition.

Yes

No

I have read and I understand the participant responsibilities of all Leadership Upper Valley participants. I am able to fully participate in Leadership Upper Valley.

Yes

No

If my application is approved and I elect to participate in Leadership Upper Valley, I hereby authorize Vital Communities and its agents and employees to use my photo image in any and all photographic, video, audio, digital, or other media, and to use, produce, and edit any such recording or image, including my voice and image in personally identifiable form, in such a manner as they or any of them shall see fit, for any purpose, in all media, throughout the world, an unlimited number of times in perpetuity, including distribution over the Internet and its World Wide Web, and including use in modified form and in combination with other images or recordings. I further authorize Vital Communities to transfer or license the rights granted under this Consent and Release to third parties for purposes consistent with the mission of Vital Communities.

Yes

No

This application is due by June 30, 2023.