a program of the Longview Chamber of Commerce
LEADERSHIP LONGVIEW Class of 2015-2016 APPLICATION
Our Mission
To strengthen and transform the community of Longview through a program of leadership development,
community study and involvement.
Why Leadership Longview?
Leadership Longview Class of 2015-2016 is designed to incorporate key leadership objectives for
community leadership including a wide community base leadership development and community
trusteeship. Participants will be given the tools necessary to question standard practices, encourage new
visions, empower others to act and make a difference in their community.
Application Instructions
Provide all the information requested in this application, relevant to your own experience and background.
Please do not attach resumes in lieu of this application. They will not be reviewed. Your application must
be signed by you and your employer and received no later than 5:00 p.m. on July 1, 2015. Candidates will
not be considered unless a complete application with the required signatures is included.
Selection
Leadership Longview Class of 2015-2016 will be selected through a blind selection process. Applicants
will be notified of the committee’s decision the third week of July. Selection will be made on the following
criteria: Commitments to civic involvement and to the Longview community; potential for community
leadership as well as professional and personal achievement. Leadership Longview will accept no more
than two applicants per employer. If more than two applications are submitted, the employer will be
contacted to determine which two applications will be considered. Applications must be answered
completely to warrant consideration. There are no guaranteed appointments or selections.
The Longview Chamber has final approval of all applicants.
Tuition
Tuition for each participate in Leadership Longview is $1075 for Longview Chamber of Commerce
members and $1,275 for nonmembers which also includes a one year membership in the Leadership
Longview Alumni Network. You will be encouraged to serve on a committee for Leadership Longview
after graduation as part of the Alumni. Tuition is payable upon notification of acceptance.
Leadership Longview has a very limited amount of financial assistance available. Those requesting
assistance must complete the Financial Assistance Form and enclose it with your LL application.
Completed applications and/tuition assistance requests are due on or before 5:00 p.m. on July 1, 2015.
Applications should be submitted electronically to Amy Canton at:
acanton@longviewtx.com
For more information contact: Amy Canton 903-261-7125 or acanton@longviewtx.com
Chamber of Commerce, 410 N. Center St, Longview, TX 75601
Financial Assistance Form
The policy of Leadership Longview is to provide a limited amount of tuition assistance to those candidates
who are accepted into the program and demonstrate financial hardship that will prevent their participation.
Award amounts are based on the number of requests received and the amount of funds available each year.
Assistance will only be granted for ½ of the tuition costs.
Consideration for tuition is based primarily on demonstrated need.
(Please erase this statement and start typing your comments in the space provided)
Applicant:
Phone:
Employer:
Address:
City:
Zip:
Please provide your reasoning for your tuition assistance request.
Applications for assistance are confidential and have no bearing on selection.
(Please erase this statement and start typing your comments in the space provided)
I confirm that the above information is a true account of my situation
Signature
Date
Leadership Longview is a program sponsored by the Longview Chamber of Commerce and
was formed in 1981 to identify potential community leaders, educate them to acquire an
understanding of the critical issues affecting our region and provide opportunities for
leadership and stewardship in the Longview area.
LEADERSHIP LONGVIEW CLASS of 2015-2016 PROGRAM DAYS
Fall Overnight Retreat
Friday & Saturday, September, 11-12, 2015
(Mandatory)
Community and Economic Development
Thursday, October 8, 2015
Tour Day
Thursday, November 12, 2015
Health and Social Services
Thursday, December 10, 2015
Criminal Justice/Public Safety
Thursday, January 14, 2016
Education
Thursday, February 11, 2016
Quality of Life
Thursday, March 10, 2016
Community Project Day
Thursday, April 14, 2016
(Mandatory)
Project Debriefing Session
TBD
Graduation
Luncheon- May 3, 2016
Leadership Longview Class of 2015-2016 Application
Please provide your responses to all application questions, in typed form, on a
separate sheet of paper. Resumes will not be accepted in lieu of the completion of
this application
Personal Information(Please erase this statement and start typing your comments in the space
provided)
Full Name:
Preferred First Name:
Home Address:
Home Phone:
Company:
Business Mailing Address:
Business Phone:
Preferred mailing address:
Preferred email address:
Zip Code:
Cell Phone:
Zip Code:
Zip Code:
Have you applied in the past (past applications do not guarantee selection)?
YES
NO
Do you require any special accommodations?
If yes please explain (allergies, medical, or physical)
YES
NO
(Please erase this statement and start typing your comments in the space provided)
SHIRT SIZE: (CIRCLE ONE)
SMALL
MEDIUM
LARGE
XL
XXL
XXXL
(These are men’s and women’s sizes – not unisex sizes) Recommendation: Order 1 size larger
How did you hear about Leadership Longview? ______ LL Alumni
______ Chamber of Commerce website ______ Newspaper ______ Friend
______ Chamber of Commerce newsletter ______ Business associate
______ Other______________________________________________________
PLEASE ANSWER EACH QUESTION USING 500 WORDS OR LESS:
1. Why do you want to participate in Leadership Longview?
(Please erase this statement and start typing your comments in the space provided)
2. Where have you focused your volunteer efforts or community involvement?
(Please erase this statement and start typing your comments in the space provided)
3. Describe your three most significant achievements/contributions through
your volunteer work or community involvement.
(Please erase this statement and start typing your comments in the space provided)
4. What do you see as the biggest challenge facing Longview today and what is
your vision to resolve or improve it?
(Please erase this statement and start typing your comments in the space provided)
5. Describe your leadership abilities and what you as an individual bring to
your future class and our community?
(Please erase this statement and start typing your comments in the space provided)

Letters of Recommendation
Attach two (2) letters of recommendation, one from a personal reference and
one from a professional reference, that includes:
o Why this applicant will make a good candidate for this year’s
Leadership Longview Class, and;
o Sites examples of their leadership abilities
Letters should be addressed to the attention of the Leadership Longview
Selection Committee.
Electronic submission of application and recommendation letters is
preferred, and should be submitted to Amy Canton at
acanton@longviewtx.com
You will be notified by email when all required documentation has been
received.
Include a professional headshot photo and a short bio with the application. The
head shot and bio will be used if selected for the class, but will not be included in the
selection process.
Application checklist: (For your personal records)
______ Personal information filled out, shirt size selected, and any special
accommodations noted (if applicable).
______ All questions answered (each question has 500 or less words).
______ Included professional headshot photo and bio.
______ Two letters of recommendation included (one personal/one professional).
______ Financial Aid application filled out (if applicable).
______ Financial, Attendance, and Time policies read, signed, and understood.
______ Ensure application is filled out completely. Incomplete applications will not
be submitted to the selection committee.
______ Application electronically submitted or before application deadline.
Leadership Longview Class of 2015-2016
Commitments for Participation
This form must be filled out completely and attached to the application to warrant
consideration in the program.
Financial Commitment
Tuition for each participant in Leadership Longview is $1,075 for Longview
Chamber of Commerce members and $1,275 for nonmembers. Financial
assistance is limited. For information on financial assistance, please refer to the
Financial Assistance Form included in this packet.
Chamber Member Tuition
Nonmember Tuition
Tuition Assistance Requested
Total Tuition:
$_______________
$ _______________
$_______________
$ _______________
Tuition includes a one year membership in the Leadership Longview Alumni
Network ($75.00) from May 2016 through May 2017.
Tuition is due September 1, 2015.
I (DO/DO NOT) give permission to the Longview Chamber to use my photo and
information provided in this application at the Longview Chamber’s discretion. I
understand that the Longview Chamber will not release my email or fax
information.
I understand that tuition must be paid in full by my company or myself (if selfemployed) on or before the deadline. Failure to pay will result in disenrollment
from the program.
I, as an applicant, understand and agree to these terms.
Applicant’s Signature
Date
Attendance and Time Commitment Policy
Full participation by each member of Leadership Longview is critical. This
includes attendance at:
(1) Opening Retreat – Friday, September 11 and Saturday, September 12 (all
day both days) (attendance mandatory – no exceptions)
(2) Monthly Class Sessions – 2nd Thursday of each month
(October-April) from 7:30 a.m. – 5:00 p.m.
(3) Community Project Debriefing Session - TBD
(4) Community Project Day – April 14, 2016 – (attendance mandatory – no
exceptions)
(5) Each participant cannot miss more than 10 hours total. This policy will
be strictly enforced. Tuition (including one year of alumni dues) will not
be reimbursed for any reason.
It is vital that you and your employer understand and honor these commitments. If you
are unable to commit to this schedule, please do not apply at this time. Applications
without your employer’s signature will not be accepted. (Electronic signatures are
acceptable).
I, as an applicant, understand and agree to these commitments.
Applicants Signature
Date
I, as the above candidate’s employer, understand and agree to these commitments.
Employer Signature*
Date
Employer Printed Name*
Title
________________________________________________________________________
Employer Work Phone*
*Not applicable to self-employed or those not employed
Electronic signatures and email submission are acceptable.