Business Leadership Program Application - Class of 2022 Class #2

Fostering Leadership Growth in Business

The Business Leadership Program (BLP) provides an opportunity for mid-level managers up to senior leaders as well as small business owners to connect, learn, and grow with those in similar positions.

The program will help you:

• Freshen up your leadership approaches
• Prepare to tackle your organization's strategic challenges
• Lead with greater confidence
• Inspire performance at all levels
• Contribute more value as a member of your company's leadership team

Business Leadership Program Course – Life Leader 360, presented by former American Woodmark CEO, Cary Dunston. Life Leader 360 will challenge you to understand your choices in life and how your life stories are being written. You will learn invaluable tools to help you create a vision for your future and begin to live your life in alignment with your true center and what is most important in your lives. With balance, you will be open to learn and apply valuable leadership principles.

First Name *

Last Name *

Applicant email address *

Please enter email address

Phone number *

Personal Information

This information is for Top of Virginia Regional Chamber internal use only.

Dietary Restrictions *

Physical Limitations *

Home Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Business Information

Business Name *

Title or Position *

Immediate Supervisor *

Business Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Business Phone *

Education

School #1

School Name *

School Location *

Degree

Major

Business or Personal Recommendation

Please list a reference, your supervisor or a personal contact, knowledgeable of your business leadership performance and potential.

Name of Reference

First Name *

Last Name *

Address of Reference

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Phone for Reference *

Relationship of Reference *

Financial Commitment

Organization/Company will fund Individual will fund

Funding may be provided by organizations/companies or individual participants. Payment is due two weeks prior to the first session.

BLP Attendance Policy

Completion of the program will be determined by presence and participation in the sessions. To ensure that participants derive the greatest benefit from the program, attendance is required at all four (4) sessions. If you need to be absent from a session, the program coordinator should be notified as soon as possible prior to the session at 540-662-4118 ext. 16, vmcallister@regionalchamber.biz or on the day of the session please text 540-550-4422.

To complete the Business Leadership Program, a participant is required to attend all four (4) sessions. I understand the above stated commitment and agree to comply. Applications are kept strictly confidential. *

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Business Leadership Program Application - Class of 2022 Class #2

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