Leadership CORPS Program Application

Thank you for your interest in participating in the Leadership CORPS program. Before you apply, please be sure that you are able to attend all Learning Days including the mandatory opening retreat on September 14 and 15, 2023.

Please note that in addition to the Learning Days, required pre-work and small-group project time is 2-3 hours per month.

The application deadline for the Class of 2023 is May 1, 2023.

The Selection Committee seeks a diverse class, representative of San Mateo County. The ideal application is thorough and demonstrates a strong desire to attend the program. The selection process may require an interview.

Please contact Karen Hager if you have any questions: karen.hager@leadershipcouncilsmc.org.

This application is four pages (including short answer questions) and is best completed in ONE SITTING (it's not possible to save as you go).

Preview of Short Answer Questions on page 4:

1. Why are you applying to the Leadership CORPS program? How do you expect to utilize your Leadership CORPS experience and what do you hope to gain from participating in the program?

2. Please share an example of effective leadership by you or someone else. How does this example shape or illustrate your definition of leadership?

3. What is an issue you feel passionate about helping to solve in your community? Have you been able to influence this issue to date? If so, how? If not, how would you like to be involved?

4. Each person brings a unique set of skills and perspectives to the class. What life experiences and perspectives do you bring to the class that makes you a unique participant?

Personal Information

Salutation

First Name *

Middle Name

Last Name *

Email *

Personal Cell Phone

LinkedIn Profile URL

Birth Date

// (mm/dd/yyyy)

Place of Birth

#Years in San Mateo County

Home Address 1 *

Home Address 2

Home City *

Home Zip Code *

How did you hear about the Leadership CORPS Program?

Emergency Contact Name *

Emergency Contact Phone Number *

Emergency Contact Relationship *

Diversity is an important part of our mission. In an effort to understand our applicants and ensure all populations are served and represented, we have a few questions we'd like to ask. Please know that: 1. This information is used to collect demographic data on our applicants; 2. The information will not be used for a discriminatory purpose; 3. Only Leadership Council SMC staff and the Selection Committee will have access to this information; 4. Your responses will be kept private and secure. Please consider answering the following optional questions.

Gender Identity

Another Gender/Self-Describe

Pronouns

Another Pronoun

Race or Ethnicity (check all that apply)

American Indian
Alaska Native
Asian
Black or African American
Indian
Latino/a/x
Middle Eastern
North African or Arab
Multiracial
Native Hawaiian
Another Pacific Islander
White or European American
Another
Prefer Not to Answer

Religion (check all that apply)

Christianity
Judaism
Islam
Baha'i
Buddhism
Hinduism
None
Other
Prefer Not to Answer

Do you identify as a member of the LGBTQ community?

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Leadership CORPS Program Application

Personal Information