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Jasper Leadership Application

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Comments

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Thank you for your interest in becoming a member of Jasper Leadership. Applications are due by Jan. 19. All applicants will be notified by early February about the status of their application and whether they were selected for the program.

Name*

First Last

Email*

Phone*

Address*

Street Address City State ZIP Code

Are you a Jasper resident?*

Yes

No

Date you Moved to Jasper*

Month

Day

Year

Are you in good standing with the Jasper Community Association?*

Yes

No

Not sure

Occupation*

Current or most recent

Employer*

Current or most recent

Why are you interested in participating in Jasper Leadership?*

What unique experience, background, or perspective will you bring to the program?*

In what ways are you currently involved in Jasper or the greater community?*

Please include events and activities you participate in and any organizations you actively support.

In what ways or in which areas would you like to get more involved in Jasper or the greater community? Please list two or three examples.*

Will you commit to participating in the classes and activities required to be inducted into Jasper Leadership?*

Yes

No

Are there any restrictions or special circumstances that may impact your participation in the program?*

Yes

No

Please explain:*

Do you need modifications or assistance to help you to have a more comfortable and enjoyable experience in the program?*

Yes

No

Please explain:*

Are there any activities in the year ahead that will cause you to be late or absent to a Tuesday evening class meeting?*

Yes

No

Please list those activities and dates:*

Do you have any additional comments to share that were not already addressed in this form?*

Yes

No

Enter your additional comments below.*

Leadership Agreement*

If selected for Jasper Leadership Class 2, I agree to:

1. Attend the Feb. 25 Jasper Leadership Class 1 kick-off, commit to the required core program meetings, and participate in the minimum number of activities discussed at the information session.
2. Actively participate in group discussions, projects and activities.
3. Respect the opinions of others, even if their opinions differ from my own.
4. Embrace the vision and values of Jasper and accept the responsibility of being an ongoing positive and proactive ambassador of the community.
5. Agree to the Jasper Leadership Statement.

I agree

Signature*

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