Join the Class
2015-2016
LEADERSHIP SANTA MARIA VALLEY
“ Preparing Tomorrow’s Leaders Today”
Leadership Santa Maria Valley is a Community Leadership Development Program designed to expand the
community’s civic leadership. Through an eleven-month program of monthly day-long workshops and seminars,
participants engage in face-to-face discussions with experts and key decision-makers in areas of vital concern to
the Santa Maria Valley. Spending time together in a small class atmosphere, individuals have an unprecedented
opportunity to become aware of the current social and economic changes, and their impact on the Santa Maria
Valley. It is also a prime opportunity to network and become acquainted with other existing and emerging
community leaders.
Vision of Leadership
To bring together people of diverse backgrounds into a community-sponsored program which will bring out the
very best in each individual for the benefit of the entire Community.
Please print application and submit to Judi Kincaid, Executive Director of Leadership Santa Maria
Valley when completed at: judi.kincaid@iglide.net http://leadershipsantamariavalley.com/
A Program of the Santa Maria Valley Chamber of Commerce and Visitor & Convention Bureau
614 S. Broadway, Santa Maria, CA 93454-5111 (805) 925-2403, ext. 812
Join the Class
PERSONAL SECTION
Full Name:
201
2015-2016
LEADERSHIP SANTA MARIA VALLEY
565
5
For Graduation Certificate (please print)
Birthdate*:
Home Phone:
Cell Phone:
Home Address:
City, State, Zip:
Email Address:
* Must be 21 years of age by or on August 21, 2015
Work Phone:
EMPLOYER SECTION
Employer:
Employer
Address:
City
Employer Phone:
Current Position:
Sponsoring Business or Organization:
How did you hear about Leadership Santa Maria Valley (LSMV)
programprogram?
,State
,Zip:
Business FAX #:
Years at Company:
Nominees for LSMV program must have the support and commitment of their sponsoring business or organization. The signature of the head of the sponsoring
organization is an indication of support of the nominee’s full participation in the LSMV program including Retreat and first Friday Topic Days
Signature of Employer or Sponsor:
Title:
Signature of Applicant:
Date:
PLEASE MAIL APPLICATION TO: Judi Kincaid, Executive Director Leadership Santa Maria Valley
1220 Emerald Drive, Santa Maria, CA 93455 * judi.kincaid@iglide.net
Join the Class
2015-2016
Leadership Santa Maria Valley
Tuition
Your tuition investment of $895.00 covers all program costs, banquet meals, and the teambuilding weekend retreat. It is anticipated that many employers and sponsoring organizations
will want to pay the tuition for their selected employee or members.
Who will pay your tuition?
My employer will pay entire fee
My employer will pay partial fee of___________ I will pay partial fee of _________
I will pay entire fee
Payment Terms -- This form is detached from your application and used by the Chamber for
your Invoices. A $150 refundable deposit is required when your application is submitted. The
deposit will be refunded if you are not selected for the program. If selected for the program, your
$150 deposit will be applied to your $895 tuition and the remaining $745 is due in full by August 10.**
If your $745 payment is not received by August 10, a payment plan will be automatically arranged for
you. You will be invoiced for 3 payments of $275 each. These three payments, along with your $150
deposit, will total a tuition payment of $975.**
1.
2.
3.
$275 will be due by August17
$275 will be due by September 28
$275 will be due by October 26
I have enclosed a check for $150. Please invoice me for the remaining $745 balance due by August10.
Signature
Please charge my credit card for the $150 deposit now and charge me for the $745 balance on August10..
Signature
Please charge my credit card for the $150 deposit now.
Charge
my card another $275 on August17
□
Charge my card another $275 on September 28
Charge my card another $275 on October 26
□
Signature
Information:: Card #
Expiration Date
Security Code
Name on Card
Card Billing Address
Billing City and State
Billing Zip
***Partial scholarships are available, a letter requesting consideration and enumerating
reasons for scholarship MUST accompany application to be considered by Board of
Directors***
No one is allowed to graduate if their tuition is not paid in full by November 28
2015. In addition you may face suspension from the program for non-payment
of your tuition.
Tuition is non-refundable after Retreat
Join the Class
2015-2016
LEADERSHIP SANTA MARIA VALLEY
Application Period March 15, 2015 - July 31, 2015
Interviews – mid- late July
Orientation/Alumni Mixer- TBD August
Kick-off Retreat*** 21-23 August 2015
Topic Days
Meet first Friday of the month except for January 2016
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Arts
and Culture- 2 Oct2015
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Public Safety- 6 Nov 2015
Youth and Education- 4 Dec 2015
Health and Human Services- 8 Jan 2016
Mid-Year Retreat ( half-day) Saturday 23 Jan 2016
Business and Economics- 5 Feb 2016
Government- 4 March 2016
Media and Technology
1 April 2016
Agriculture- 6 May 2016
Leadership- 3 June 2016
Graduation Saturday, 10 June 2016
**** Attendance is mandatory for the entire Retreat****