25th Annual Leadership Southern Arizona - Sky Islands Regional Partnership

First Name *

Last Name *

Email *

Applicant Information

Address *

City *

State *

Zip Code *

Cell Phone *

Work Phone *

Please upload a professional photo. *

What is your shirt size?
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Education

College

From - To (Ex.: 2009 - 2013)

City, State

Did you graduate?

Yes

Degree

Other

From - To (Ex.: 2009 - 2013)

City, State

Did you graduate?

Yes

Degree

Employment
Please list most to least recent

Company *

Job Title *

Dates of Employment (Ex.: 01/2018 to 06/2020) *

Responsibilities *

Supervisor *

Address *

Phone Number *

Company

Job Title

Dates of Employment (Ex.: 01/2018 to 06/2020)

Responsibilities

Supervisor

Address

Phone Number

Please upload your resume. *

Provide two references who are knowledgeable about your leadership performance and potential.
Please include their name, relationship to you, and their phone number. *

Upload a statement from your supervisor acknowledging your application to this program and their confirmation that you will attend every class. *

Leadership Evaluation

How does your current position relate to providing leadership to southern Arizona? *

What leadership roles do you hold outside of your workplace at this time (if any)? *

What do you consider to be your most important civic contribution? *

What is it about your volunteer and civic activities that you enjoy most? *

What do you feel are the three most significant problems facing southern Arizona today? *

What do you feel needs to be done to address one of these issues? *

Why do you think you are a good candidate for this program? *

What are your expectations of this program? *

Leadership Southern Arizona Scholarship

Would you like to apply for one of the available Leadership Southern Arizona Scholarships?

Yes

Scholarship Information & Agreement – Leadership Southern Arizona

The Leadership Southern Arizona Committee will review all scholarship applications and make award decisions based on demonstrated financial need.

To be eligible for a scholarship:

Applicants must be current members of the Chamber of Commerce
Applicants must agree to attend and complete the full program schedule

The scholarship will cover $850 of the program cost.

By applying for this scholarship, I acknowledge and agree to the following:

I will participate fully and graduate from the Leadership Southern Arizona program
If I fail to complete the program or do not graduate, I understand that I am responsible for repaying the full scholarship amount of $850 to the Sky Islands Foundation within 30 days of exiting the program

Yes

If you are not chosen for the Scholarship do you still want to be considered for this program?
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Health & Safety
During the Leadership Southern Arizona program schedule, there is physical activity which includes, but is not limited to, walking, standing, stairs, and sitting for extended periods of time.
If you require ADA accommodations, provide information on reasonable accommodations below.
If you have dietary restrictions, please complete the form below.
The Sky Islands Foundation follows CDC recommendations for the health and safety of all our participants and program partners. Social Distancing and the use of masks are encouraged throughout the program. This program includes stops at facilities that may require the use of a mask and social distancing.
This program encounters varying weather conditions. Close-toed walking shoes are required. Ensure your comfort and health by dressing in layers, bringing sunscreen, a hat, an umbrella, a water bottle, and sunglasses each day.

Describe the ADA accommodations needed:

Describe the dietary restrictions:

Commitment

I understand, completion of an application does not guarantee selection into the upcoming class.
I understand space is limited and all applications are reviewed by a committee who will select the candidates for this year's program.
I also understand, if selected to participate in the program, payment in full is due on or before January 29th, 2026.
I understand if payment is not made in full prior to the start of the program, my slot will be offered to a student on the waiting list.
I understand that there are no refunds.
I understand that I must attend ALL of the scheduled sessions in full.
I understand that I may miss only one class and still be allowed to graduate.
I understand that if I miss more than one class, I will not be allowed to graduate and will have to reapply to attend the next year's class.
I understand there is no guarantee that I will be accepted into the next year's class. I understand that if I am accepted into the next year's class, that I will be required to pay for the class in full.
I understand and agree to remain focused during all presentations and networking throughout each session.
I understand and agree to respond to work or personal texts, phone calls, and emails only during designated breaks.
I understand that I must provide my Social Security number and driver’s license number for a confidential background check conducted by the Brian A. Terry Border Patrol Station prior to Border Day.
I understand that I will be REQUIRED to obtain a Fort Huachuca gate pass PRIOR to the Fort Huachuca Day.

Payment Information:
Sky Islands Regional Partnership Member $850.00
Non-Partnership Member $1050.00
If you are selected to attend this year's program, payment is due by January 29th, 2026.

I acknowledge that a gate pass is REQUIRED for access to Fort Huachuca and agree to obtain the necessary pass PRIOR to Fort Huachuca Day.
Please initial below to confirm your understanding and compliance. *

Digital Signature - By digitally signing this form I agree with all terms and instructions *

Please sign below using your mouse or your finger on a touchscreen device

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