Leadership Allegany Application

Name


Home Address





Do you have any dietary restrictions?

Employment Information

Employer Address





Employment

Education

Community and other Activities

List any volunteer activities, board memberships, committees, organizational memberships, and/or other pertinent activities you've engaged in. Limit this to the five most recent and/or most relevant activities:

Personal Achievement

Miscellaneous

Are you:

Commitment Agreement

In order to successfully complete and graduate from Leadership Allegany, participants are expected to attend all of the sessions. However, we understand some personal or professional conflicts may arise. Students are allowed a maximum of two absences. Students will be dismissed from the program for any additional absences, with an option to re-start the following year only. Sponsorships and scholarships are non-refundable. By signing the commitment below, you acknowledge your acceptance of this policy. We strongly recommend you share this policy and the program calendar with your employer when obtaining approval to participate in Leadership Allegany. The program includes a full day opening retreat followed by two half-day sessions per month and concludes with graduation. The program typically runs from early-May through mid-February.

If selected, do you agree to the attendance requirements as stated above?

mm/dd/yyyy

Letters of recommendation

Please have two professional letters of recommendation sent by email to: events@houghton.edu
or
mail to: Leadership Allegany, PO Box 174, Houghton, NY 14744

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