2025 LNS Application
Application
First Name
Last Name
Preferred Name
Date of Birth
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Personal Email
Cell phone
Street Address, City, State, Zip Code
Spouse's name/Emergency contact
Children's ages
Number of years in St. Tammany
Current Employer
Hire Date
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Mailing Address, City, State, Zip Code
Work Email
Email Preference for LNS
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Work Phone
Work Fax
Type of Business
Job Title
Length of time at job
Briefly describe your responsibilities at work
Do you have your employer's approval?
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Employer's phone number

Briefly summarize your education background. List degrees/certificates received, field of study, vocational training programs, professional institutes, etc. List extracurricular activities and special honors received.  

Please list any organizations to which you belong.  

To graduate from LEADERSHIP NORTHSHORE, each participant is expected to attend ALL sessions. Only One (1) Absence is allowed. If more than one class session is missed, you will be required to make it up the following year. You will receive your certificate of completion after the required sessions have been completed.   

•       Opening Weekend Retreat (Mandatory Attendance)

•       Nine full day sessions (See PDF Schedule on website)

•       Four evening meetings during the year that include spouses

•       Closing two-day retreat (Mandatory Attendance)

Tuition for each participant is $1,200.00. $100 is required with application form. (Refundable if not selected.)  

Do you understand the requirements?

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A limited number of partial scholarships are available. If accepted into LEADERSHIP NORTHSHORE, will you find it necessary to seek scholarship assistance toward the tuition fee?   

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Deposit paid *
Tuition will be paid by *
T-shirt size
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Food allergies

Interesting Fun Fact Others Might Not Know About You

I understand the purpose and commitments of the LEADERSHIP NORTHSHORE Program; and, if I become a participant, I will devote the required time. I understand that more than one absence will mean that I will not graduate with my beginning class.   

I certify that the information provided in this application is true and correct as of the date set forth opposite my signature on this application and acknowledge my understanding that any intent or negligent misrepresentation of the information contained in this application may result in dismissal from the class.   

I hereby give LEADERSHIP NORTHSHORE permission to share this information for public relations and reports.  

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