Leadership Illinois Class Application
Leadership Illinois invites qualified candidates to apply during the enrollment period of April 1st –December 1st. To
be considered for selection into the class, please complete the following application (online) and send in the
required documents by December 1. Candidates will be notified of Leadership Illinois’ decision no later than
March 1.
Required information
Name: ___________________________________________________________________________
Date of birth: ______________________________
Home Address: _____________________________________________________________________
street
city
zip
Organization/Employer: ______________________________________________________________
___ For profit business ____ Non-profit business
Position/Title: ______________________________________________________________________
Employer Mailing Address: ____________________________________________________________
street/building
__________________________________________________________________________________
(address continued) *county
city
zip
Employer website: ___________________________________________________________________
Where do you prefer to receive mail? Home____ Business______
Preferred phone: ______________________________Second phone: __________________________
Email address: ________________________________________
Optional information:
Leadership Illinois is committed to diversity and encourages applicants of all ethnic/racial groups to seek
membership. The following information is not required but will help us ensure we meet our commitment. Please
check the description that best fits you:
___ Native American/Alaskan native ____White/Caucasian ____ Hispanic ____ Asian American
___ Native Hawaiian/Pacific Islander ____ Black/African American ____ other (describe) _____________
Recommender Information:
Leadership Illinois seeks two recommendations that help us better understand candidates’ leadership in the
workplace and in the community/civic arena. Applicants are welcome to seek letters from Leadership Illinois
alumni.
Name of business recommender: __________________________________________________________
Leadership Illinois member? ____ yes ____ no Telephone: _____________________________________
Email address: _________________________________________________________________________
Your relationship to the recommender: _____________________________________________________
Name of civic/community recommender: ___________________________________________________
Leadership Illinois member? ____ yes ____ no Telephone: _____________________________________
Email address: _________________________________________________________________________
Your relationship to the recommender: _____________________________________________________
Was there a Leadership Illinois alum who introduced or encouraged you to apply?__________________
Application Narrative:
On a separate sheet of paper (or, in the boxes provided in an online application) please respond to the following
questions.
1. Describe why you would be an asset to the Leadership Illinois program, including special talents you will
bring. (500 words)
2. Describe your current or recent position/role and the leadership accomplishments you consider most
significant in your development as a leader. (500 words)
3. List the most important award or recognition you have received and briefly explain why you feel it is most
important. (500 words)
4. Describe your role in 2-3 important civic/community leadership experiences. (500 words)
5. Please attach your current resume and be sure to include mention of your civic/community involvement.
Financial Assistance:
Leadership Illinois has a limited number of scholarships available to applicants who face challenges in fully funding
the experience. Please check appropriate boxes.
____I, or the organization I work for, am prepared to cover the tuition and travel/lodging expenses if I am
accepted.
Do you wish to be considered for a partial scholarship? ____ yes ____ no
If yes, what amount under $1000 would you like to be considered? _____________
If you are requesting a scholarship, please describe the circumstances of the need. If you will receive partial
support from your organization, please indicate what they will and will not fund.
Conference information:
The conference dates and locations are similar each year. Please refer to the website for the most updated
schedule for the coming year:
Mid-May ,
Mid-July ,
Mid-September,
The Power of the Government, Springfield
The Power of the Individual, city changes annually
The Power of the Marketplace, Chicago
Class members must complete all three sessions in their entirety in order to graduate from the program. We
require all class members to stay at the hotel regardless of home location. This requirement serves several
purposes: It promotes relationships among class members and allows for full immersion in the Leadership Illinois
experience. It also ensures that members arrive on time to scheduled programming and allows Leadership Illinois
to negotiate preferred rates for conferences with no added fees for numbers not meeting hotel expectations. We
appreciate your understanding of this policy.
Class members who are unable to attend portions of the conference will need to re-attend the session day in the
subsequent year and pay associated costs for the missed day. Late arrivals, early departures and changes related
to the hotel or conference attendance require prior approval from Leadership Illinois. Emergencies are always
taken into consideration and addressed on a case by case basis.
Tuition for the three conferences is $1600.00, which includes the first year’s annual membership dues. Upon
notification of selection to Leadership Illinois, class members are required to pay tuition in full by April 1 to hold
their place in class. Expenses to attend conferences, such as travel, lodging and meals outside of the conference
are not included in the fee and are the responsibility of the participant.
Please indicate any disability that might require accommodation at the conferences:
__________________________________________________________________________________
Please indicate any food requirements you have: _____________________________________________
Candidate Certification:
I certify that all of the statements made in this application are true, complete and accurate to the best of my
knowledge and have been made in good faith. I know and understand that any and all components of my
application may be verified by Leadership Illinois. If selected, I have company/organization support for my
participation, where applicable, and will attend the three conferences. Further, if selected, I will arrange for
immediate payment of the $500 tuition deposit with the balance of the tuition paid by April 1 of the year in which
I am applying.
________________________________________________________________________________
Candidate Signature
Application Checklist:
__ Fully completed and submitted application form
__ Current resume (no longer than 2 pages)
__ Fully completed application narrative responses
__ Two letters of recommendation in business and civic/community categories
__ Application and all documentation completed and submitted online by December 1 of the year in which I am
applying.
The application and required documents should be mailed to: (if not completed online)
Leadership Illinois
PO Box 5108
Bloomington, IL 61702-5108
Your application will not be considered by Leadership Illinois unless all documents are received by the December
1st deadline. You will receive a final decision from Leadership Illinois by March 1.