SERVING UP LEADERSHIP – Kenneth Stiles

February 9 @ 12:00 pm - 1:00 pm

Feb 24

DINNER AT THE SQUARE – Have We Done Enough?

February 24 @ 7:00 pm - 8:30 pm

APPLY FOR LEADERSHIP BROWARD CLASS XL

Leadership Broward Foundation

LB Class XXXIX had a phenomenal Business Day via zoom yesterday thanks to our amazing...

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You don’t want to miss the next Serving Up Leadership with the CEO of Stiles,...

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Leadership Broward Foundation

Here’s to brighter days and happier tomorrows. We can’t say it enough...THANK YOU for your...

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Leadership Broward Foundation

Please help us congratulate Vee Escarment, current member of Class XXXIX, for being chosen as...

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TESTIMONIALS

Leadership Broward not only showed me a unique ‘behind the scenes’ look at our community but also introduced me to the various non-profits that give back to those in need. I’m more involved now than ever….and I love it!”

JEFF CATO, Agency Owner Cato Insurance Group, Inc.

LB CLASS XL APPLICATION

You can save your work by clicking the Save link at the bottom of this page.

Name*
First Middle Initial Last
Cell Phone*
Email*
Home Address*
Street Address City State ZIP Code
Length of Residence in South Florida area*
Date of Birth*
Date Format: MM slash DD slash YYYY
Your Gender*
- Female
- Male
Persons with a disability?*
- Yes
- No
Ethnicity*
- American Indian or Alaska Native
- Asian
- Black or African American
- Caribbean American
- Hispanic or Latino
- White
Full name to be listed on name tag
Are you a previous applicant for the Leadership Broward program?*
Preferred Mailing Address*
Preferred Phone Number Listing in Members Only Directory*
EMPLOYMENT
Please list current employment and attach resume below (optional).
Current Employer*
Title*
Length of Time with Employer (Years/Months)*
Address of Employer*
Street Address City State ZIP Code
Business Phone*
Business Email*
In which sector do you work?*
- For-profit
- Government
- Nonprofiit
Which best describes your type of business? (Your answer is for internal reporting purposes only and will not affect the strength of your application)*
- Financial
- Health Services
- Legal
- Local Government
- Marketing
- Nonprofit
- Public Relations
Number of Employees
- More than 250 employees
- 50 – 250 employees
- Less than 50 employees
Previous Employment or Attach Resume Below
Upload Resume (Optional)
Drop files here or
EDUCATION
School/University (if none, type N/A)*
School/University City
School/University State
Highest Degree Level Pursued
- Associates
- Bachelors
- Masters
- Doctorate
Major (and minor if applicable)
Graduated?
Dates of Education*
(Month/Year to Month/Year)
Other School/University Information
PROFESSIONAL AND OCCUPATIONAL ACTIVITIES
Organization Name*
Organization Dates of Participation*
(Month/Year to Month/Year)
Position Held*
Responsibilities
Organization Name 2
Organization Dates of Participation 2
(Month/Year to Month/Year)
Position Held
Responsibilities
Other Professional and Occupational Activies
VOLUNTARY COMMUNITY ACTIVITIES
List the key non-professional activities (charity, religious, school involvement, task forces or commissions) in which you have actively participated in the last 3 years.
Volunteer Organization*
Volunteer Dates of Participation
(Month/Year to Month/Year)
Position Held
Responsibilities
Volunteer Organization 2
Volunteer Dates of Participation 2
(Month/Year to Month/Year)
Position Held
Responsibilities
Other activities
In an average month, approximately how many hours do you spend on voluntary community activities?*
SPECIAL HONORS/AWARDS
List any professional or community honors or awards you have received
ESSAYS
Please answer in the space provided limiting each response to 100 words or less. No attachments please.
What do you consider to be your most significant professional or community contribution?*
What do you consider the most significant issue facing Broward County today?*
Why should you be selected for the Leadership Broward Class?*
REFERENCE FORMS
The applicant must include two completed Reference Forms from different people. This form is available on the application page of the LBF website. If you do not have the completed forms available right now, you can submit your application today and email the forms by the 6/4/21 application deadline to apply@leadershipbroward.org.
Upload 2 References Forms
Drop files here or
EMPLOYER CONSENT FORMS
Applicants must have the support of their employer. This form is available on the application page of the LBF website. If you are self-employed or you are the CEO/ED/President, there is no need for the consent form. If you do not have the completed form available right now, you can submit your application today and email the form by the 6/4/21 application deadline to apply@leadershipbroward.org.
Signed Employer Consent Form
TUITION
If accepted into the Leadership Broward Class XL, you and/or your employer will be invoiced for a tuition fee of $2,600. In order to hold your seat in the class, you and/or your employer must submit payment no later than 5:00 p.m., Friday, August 20, 2021.
Will your employer be responsible for your tuition?*
Will a sponsor be responsible for your tuition?*
Applicant Acknowledgment of Commitments
The dates of the local overnight retreat are Friday, September 17, 2021 - Saturday, September 18, 2021. Full participation at the retreat is mandatory, no exceptions.*
- I agree to participate in the overnight retreat
- I do not agree to participating in the overnight retreat
Tuition must be paid by Friday, August 27, 2021 and all parties previously listed in this application are responsible for payment to Leadership Broward Foundation, Inc.*
- I agree.
Class members must participate in one full-day session per month from October 2021 to May 2022. Class members must also participate in a group community project. No class member may miss more than two program days and graduate. No exceptions.*
- I understand and agree to fulfill the requirements listed above in order to graduate from the Leadership Broward Program.
LBF will provide transportation during each program day. Class members are REQUIRED to utilize provided transportation during all program events. Personal vehicles or other forms of transport cannot be used during the program day. Class members are responsible for transportation to and from the pick up/drop off location.*
- I understand and agree to the transportation terms listed above.
Photographs are taken throughout the program year. Participants must consent to the use of these photographs in any literature or videos related to Leadership Broward Foundation, Inc. for marketing and/or informational purposes.*
- I agree.
Participants will be bound to the Leadership Broward Foundation Code of Conduct policy, as amended from time to time. Failure to adhere to this Code of Conduct may result in your removal from the Leadership Broward Program.*
- I agree.
I understand the goals and commitment of the Leadership Broward program and the attendance requirements. If selected, I will fulfill all obligations outlined in this application and will see to payment of my tuition upon acceptance. I acknowledge that I have completed the application and that all information contained herein is true and correct. I hereby give Leadership Broward Foundation, Inc. the right to make inquiries regarding the information provided on this application form. Please write your full name below, this serves as an electronic signature.*

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UPCOMING EVENTS

SERVING UP LEADERSHIP – Kenneth Stiles

DINNER AT THE SQUARE – Have We Done Enough?

APPLY FOR LEADERSHIP BROWARD CLASS XL

Leadership Broward Foundation

TESTIMONIALS

LB CLASS XL APPLICATION

EMPLOYMENT

EDUCATION

PROFESSIONAL AND OCCUPATIONAL ACTIVITIES

VOLUNTARY COMMUNITY ACTIVITIES

SPECIAL HONORS/AWARDS

ESSAYS

REFERENCE FORMS

EMPLOYER CONSENT FORMS

TUITION

Applicant Acknowledgment of Commitments