Apply – Leadership Pinellas

Question*
How will you contribute by being a member of the current class and to the community and Leadership Pinellas as a future alum?
Leadership Pinellas Profile Features
Leadership Pinellas is committed to connecting classmates and building relationships with the greater Leadership Pinellas community. We will feature each class member on Leadership Pinellas’ LinkedIn and Facebook pages throughout the year in order to help you build those connections. Please provide the following information for your program feature.
Please upload a headshot*
A LinkedIn profile picture or similar will be fine.
Max. file size: 10 MB.
Please upload your company's logo*
Max. file size: 10 MB.
Short Bio
Provide what you would like the Leadership Pinellas community to know about you. (Minimum word count 100, maximum word count 150).
Permission to Use Image/Testimonial Data*
I give Leadership Pinellas, the absolute right and unrestricted permission to take, use my name, testimonial and biographical data and/or publish, reproduce, edit, exhibit, project, display and/or copyright photographic images, pictures, video or recordings of me through any form of media (print, digital, electronic, broadcast or otherwise) for art, advertising, recruitment, marketing, fundraising, publicity, archival or any other lawful purpose. I waive any right that I may have to inspect and approve the finished product that may be used or to which it may be applied now and/or in the future, whether that use is known to me. I understand that virtual programming may be recorded and grant permission for Leadership Pinellas and/or any person(s) or entities authorized on Leadership Pinellas’ behalf to record, tape, film, photograph, edit, alter, digitize, or otherwise capture and preserve in permanent from my name, likeness, biographical material, voice, and/or performance/display. I further grant permission for Leadership Pinellas or any person or entity authorized by it, to broadcast, publish, or transmit all or any portion of the recording or altered/edited recording in any form, via any means.
- By checking this box, I indicate that I have read and understand the above.
Leadership Pinellas tuition is due in full by August 6, 2024.
Tuition Selection*
Choose single occupancy for private room or double occupancy to share a room with a same-gender classmate on both overnight experiences (Opening Retreat & Tallahassee trip).
- Single Occupancy Tuition $3,750
- Double Occupancy Tuition $3,000
Who will pay your tuition?*
Will you be requesting tuition assistance?*
- Yes
- No
Have you ever plead guilty, no contest or been convicted of a Felony?*
- No
- Yes
Employer Commitment*
Please upload a letter or email from your direct supervisor/employer stating their awareness and acceptance of the dates, time and financial obligation (if business is paying) of Leadership Pinellas. The letter should state something similar to: “This candidate has my full support to participate in Leadership Pinellas. I am aware of the date and time commitment involved in his/her effective participation as well as the financial obligation.”
Max. file size: 10 MB.
Applicant Personal Commitment*
I understand the Leadership Pinellas goals and will devote the time necessary to complete the program. This includes attendance at the two-day Opening Retreat, all program days, and the three-day Tallahassee Trip. I understand that missing any portion of a program day will constitute an absence. More than ONE absence will result in my not graduating with my class. I can make up additional missed program days up to two in the following program year in order to graduate from the program. I understand that tuition is NOT refundable in whole or in part after the Opening Retreat materials are due.
- By checking this box, I indicate that I have read and understand the above.
Signature*
Please type your full name.
Date*
MM slash DD slash YYYY
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YOUR APPLICATION PROCESS IS NOT COMPLETE UNTIL YOU'VE SUBMITTED YOUR APPLICATION FEE VIA THE LINK ON THE NEXT SCREEN.
Phone
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The Class of 2025 Application Season is Now Open Until May 1, 2024

Leadership Pinellas Application

Leadership Pinellas Profile Features

Leadership Pinellas tuition is due in full by August 6, 2024.

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