Leadership Catawba Application - The Chamber of Catawba County

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Application

Since 1974, Leadership Catawba has provided the opportunity to connect on a deeper level to our county and interact directly with key community leaders, preparing individuals to grow personally and professionally as a future leader. The program challenges each participant not only to be an effective and influential leader within their own organization, but to lead within our greater community through personal commitment and involvement.

Over the 8-month duration, participants are immersed in community issues and challenges that we position ourselves to directly address in the areas of Reinventing Community, Telling our Story, Workforce Connectivity. Building for Jobs, Serving our Community, and Small Business and Entrepreneurship.

Please complete each section, limiting answers as specified. Application deadline is May 23, 2025, or when the class reaches capacity of thirty-six (36), whichever comes first. Participants are selected on a first-come basis once the online application process has opened. A delay in submitting a completed application may result in being placed on the wait list for the 2025-2026 program.

Statement of Attendance and Commitment:

The Leadership Catawba program extends over an eight-month period beginning with Orientation and a Retreat in August. Participants attend a total of six full-day and six half-day program sessions from September through February, with graduation held in March 2026.

To graduate, attendance at all scheduled events is expected; attendance at Orientation and the Retreat is mandatory. No more than 12 total hours may be missed to complete the program and graduate.

Do you commit to the attendance and participation guidelines above?

Yes No

Please upload a professional high resolution color headshot for marketing and promotion. Image requirements: 300 dpi at 5”w x 7”h at minimum (1500 px x 2100 px).

If employed, will your employer support your participation in the 2025-2026 Leadership Catawba Program?

Yes No

All Leadership Catawba graduates agree to volunteer for a community service organization within one year of graduating from Leadership Catawba. If selected as a participant, will you agree to fulfill your volunteer commitment?

Yes No

If selected as a Leadership Catawba participant, I will commit the necessary time and effort to complete the program. I understand that no more than 12 hours may be missed to complete the program and graduate.

Yes No

Personal Data

Name (First & Last)

Preferred Name (for nametag)

Title/Position

Email Address

Work Phone (xxx) xxx-xxxx

Mobile Phone (xxx) xxx-xxxx

Emergency Contact Name

Relationship

Emergency Contact Phone (xxx) xxx-xxxx

To help us ensure a safe experience, please note required dietary needs, medical restrictions or physical limitations we need to take into consideration

Employer Data

Direct Supervisor Name/Title

Employer

Employer Address

Vision and Leadership

Why do you want to participate in Leadership Catawba and what do you hope to gain from the experience?

What is your vision for Catawba County?

In your judgement, what are the three most pressing challenges facing Catawba County today? What are your recommendations for meeting these challenges?

Please list, in order of importance to you, up to five community, civic, professional, social or other organizations in which you are or have been involved or belong:

How will your background, experiences, skills and assets add to the diversity of the Leadership Catawba class?

Tuition
Tuition for Leadership Catawba is $1,550 (Chamber partners) and $1,950 (general public) and is due by July 17, 2025. Tuition covers program costs including the retreat, meals and graduation. Upon invoicing, payment may be made by check or credit card (with 3% convenience fee). If an applicant cancels within 15 business days prior to Orientation (by July 17, 2025), one-half of the full tuition will be forfeited. If an applicant cancels after July 17, 2025 the entire tuition will be forfeited.

I have read, understand and agree to the statement above.

I agree

Release form
In consideration of agreeing to participate in the Leadership Catawba program, the Participant hereby releases the (i) Catawba Chamber (the "Chamber"), its agents, officers, servants and employees and (ii) any third parties providing facilities or work space access to the Participant while engaged in the Leadership Catawba program, from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or relating to any loss, damage or injury that may be sustained by the Participant or any property of the Participant while engaged in or under the control or supervision of the Chamber during the course of the Leadership Catawba program. The Participant is duly aware of the risk and hazards inherent in participating in physical activities associated with trust and team building activities of Leadership Catawba and is also aware of the potential risk and dangers inherent in workplaces and other locations the Participant may visit during the course of the Leadership Catawba program. The Participant hereby voluntarily assumes all risk of loss, damage or injury that may be sustained by him or her or any property belonging to or in the possession of the Participant while engaged in the Leadership Catawba program. Furthermore, to the extent that negligent or reckless actions of the Participant may cause damage to the workplace or facilities of third parties assisting with the Leadership Catawba program, Participant agrees to indemnify and hold harmless Catawba County Chamber from liability for such damage or injuries to third practices attributable to the negligent, reckless and/or intentional acts of the Participant.

Release Signature

Photograph and Media Release
I understand that photographs and video may be taken of the participants during the course of the Leadership Catawba program. I consent to such photographing and videotaping for the use by Leadership Catawba and The Chamber, without compensation, of my name, image, likeness, whether in film, photographs or any other media for the promotion by The Chamber of Leadership Catawba and other activities of The Chamber.

Photo Release Signature