LCR Application for Class of 2025 - Capital Region Chamber

LCR Application for Class of 2025

Leadership Capital Region is a locally renowned program that teaches leadership through community engagement and exposure to the most important issues, businesses and individuals in the Capital Region. Applications are being accepted until 5 p.m. Friday, May 3, 2024.

*This application form does not have a save feature, please begin your application when you are fully prepared to complete the form and all documents are ready to upload.

** Documents needed include:

Employment history, past three roles at current company or past three employers, word doc or PDF
Personal Statement, 250 words, word doc or PDF
Letter of Recommendation
Statement of Financial Need, (if applying for financial assistance)
Signature form

Please contact Sami Gowan at sgowan@capitalregionchamber.com with any concerns or questions

Fields marked with an * are required.

LCR Application Instructions *

Application must be completed in full, be signed by candidate, candidate’s employer, and/or financial sponsor (or candidate himself/herself). It must include a Letter of Recommendation and a $100 nonrefundable deposit.
Incomplete or late applications will not be considered.
Application, letter of recommendation and deposit must be received by 5 p.m., Friday, May 3, 2024 to be considered for the Class of 2025.
For the deposit, make checks payable to: Capital Region Chamber Foundation, or pay by credit card on the Chamber website https://capitalregionchamber.com/paymybill/. When paying the deposit online, please list “LCR deposit” as the invoice # and include the applicant’s name in the description field.
You may mail or hand-deliver the $100 nonrefundable deposit to:

Capital Region Chamber, C/O Leadership Capital Region, 5 Computer Drive South, Albany, NY 12205.

For questions regarding the application contact Sami Gowan at (518) 431-1414 or sgowan@capitalregionchamber.com

I undertand these instructions

Personal Information: First Name *

Last Name *

Middle Initial

Preferred name/nickname

Preferred Pronouns

Company/Organization *

Position/Title *

Business Address, Street, City. State, Zip *

Business Phone *

Business Email *

Home Address, Street, City, State, Zip *

Personal Cell Phone *

Preferred Mailing address *

This address will be used to send your formal acceptance letter. Please select the best address for you to receive mail.

Business

Home

Preferred email address *

Business

Home

Number of years in the Capital Region? *

How did you learn about Leadership Capital Region? *

Limit 200 characters.

Briefly describe your current job responsibilities. *

Feel free to list or bullet point.

What do you consider your most significant work achievement or contribution? *

Limit 200 characters.

Employment History *

Please upload your past three positions held with either your current or previous employers. Please list in chronological order, do not attach a resume, a word document is acceptable.

20MB max

Community Action *

Leadership Capital Region is very focused on community involvement, though, community service, volunteerism or board service. Please describe your level of community involvement and why it is important to you. If you are not currently engaged, that's ok too, please let us know.

Limit 200 Characters

Which types of community service organizations would you like to learn about, and why? *

Limit 200 characters.

Professional and Community Organizations *

Please list, in order of importance to you, up to three civic, professional or community organizations of which you are a present or past member. Please note any leadership positions held. Feel free to list or bullet point.

Limit 200 characters.

Personal Statement *

Leadership Capital Region is a transformational program for existing and emerging regional leaders. This program provides the foundation for a lifelong commitment to leadership and community engagement by creating awareness of key issues and opportunities that affect the Capital Region. Please explain why you are interested in joining LCR, why you should be considered for this program, and what you hope to gain from the experience.

*Please limit your response to 300 words

20MB max

Letter of Recommendation Requirement

Please upload one letter of professional reference

Ask your reference to submit a letter limited to two pages that addresses:
- The relationship between the both of you
- Your community activities or professional accomplishments
- Your leadership capabilities
- Why you would be an excellent candidate for LCR

20MB max

Reference Name *

Title *

Organization *

Relationship and Years known *

Participation Agreement and Financial Agreement *

PARTICIPATION AGREEMENT / ATTENDANCE: Full attendance at all eight full-day sessions, (one Friday a month from October – May), is required. Two emergency absences will be allowed. Attendance at the entire two-day opening retreat and full day closing session are MANDATORY for participation in the 2025 class. The mandatory two-day retreat will be held in September 2024. A class project and experiential learning components are outside of the structured program these additional time commitments are required.

TUITION. Full tuition for Chamber Members is $3,100; $3,600 for non-Chamber Members. There is a discounted rate for small community based non-profit organizations that are Chamber Members, $2,500. A $100 nonrefundable deposit is required with the application, which, if accepted, will be applied toward tuition. The remaining balance is to be paid by the employer, a financial sponsor, or by the participant himself/herself. Tuition is non-refundable. Candidates are expected to secure their own financial sponsors. Tuition must be paid in full by Friday, August 9, 2024.

I agree to the attendance, participation and financial terms

Scholarships

Financial assistance may be available on a limited basis, for applicants who intend to self-pay and will not be sponsored by their employer. Scholarships are based on need, the number of requests received, and the amount of funds available. If you wish to apply for tuition assistance, please state the amount requested.

Statement of Financial Need

Please attach a single sheet detailing your reason for the request.

20MB max

Signatures *

Upon completion of this application, please submit the signature form available on our website.

Please sign and date as indicated and have your employer sign and date as well to approve your time commitment and permit your participation in the program.

This form can be scanned and emailed to sgowan@capitalregionchamber.com or mailed with your deposit check.

I agree

Additional Information *

Regarding Leadership Capital Region and the application process, contact Sami Gowan

(518) 431-1414 sgowan@capitalregionchamber.com

All applicants will be interviewed by the program Co-chairs and Chamber staff between May 30 and June 20, 2024.
Participants will be selected based on leadership, community involvement or desire to get involved, and other relevant factors.
The Capital Region Chamber recognizes the value to learning and growth that comes with having a diverse and inclusive class. We strive to increase the diversity of participants including age, race, color, national and ethnic origin, religion, gender, gender identity and/or expression, sexual orientation, military or veteran status, marital status, disability, socio-economic status, and work experience. Our goal is to create a program that is representative of the diversity in our region, and to co-create with each class an environment that is equitable, respectful, and appreciative of difference.
All applicants will be notified by July 15 of their acceptance status, by email and formal letter.

I acknowledge.

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