2025-2026 Leadership Lawrence Program - Adult Application

You're one step closer to joining our next Leadership Lawrence cohort!

The online application must be completed in its entirety during one session. It will take approximately 10 minutes to complete.

If you need any accommodations or assistance with completing the online application, we will gladly offer our help. Please reach out to our office by emailing info@lawcotn.com.

Fields marked with an * are required.

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Personal Information

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

State *

Postal Code *

Email *

Phone *

Cell Phone Number

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Employment Information

Organization *

Address Line 1

Employer Address

Address Line 2

City *

State *

Postal Code

Phone

Month/Year you joined or founded your current organization *

Current Title *

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Employment Information

Emergency Contact Name *

Phone *

Emergency Info

Relationship *

Please list any allergies or medical conditions we need to be aware of.

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Demographic Info

Gender *

Age *

Birthday *

Race/ Ethnicity

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Questions

1. *

Why have you applied for admission to Leadership Lawrence? (What do you bring to the program/ what do you hope to gain?)

2. *

Describe an issue/opportunity facing Lawrence County that is the most important to you. What role do you play or do you intend to play in the future of this issue?

3. *

What would you consider to be your biggest accomplishment?

4. *

Please list in order of importance up to five community, political, civic, professional, business, religious, social, athletic, or other committee or organizations in which you have been involved.

5. *

Hobbies and Special Interests:

6. *

Because there are more applicants for Leadership Lawrence than there are spaces, we must ask that participants commit to attending 100% of the year’s program. Absenteeism may result in being dropped from the program. If you are unable to make this commitment, it is not in your best interest to apply at this time.

Are you and your employer willing to make such a commitment?

Yes

7. *

Tuition for the Leadership Lawrence program is $950. Who will be responsible for tuition payment – you or your employer?

Employer

Self

Other

Please verify that you have checked the “I'm not a robot” checkbox.

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