LEAP - MENTOR Application

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YOUTH LEADERSHIP MENTOR APPLICATION

The Youth Leadership Initiative, LEAP, is a program sponsored by the Leadership Pocatello-Chubbuck Chamber of Commerce. LEAP is a one year program, with an opportunity for the students to mentor the second year. A new class will start each year in October. The program year involves attending one full day class each month where mentors will teach and facilitate to the students leadership training and learn about the community. Days may include but subject to change,
topics like Industry Day, Healthcare Day, Judicial Day, Law Enforcement Day, Government Day, Social Services Day and more. There is also a curriculum identified as part of the program to be utilized by the mentors.

*If you have Graduated from the Pocatello - Chubbuck Chamber of Commerce Leadership Program and qualify as a Leadership Alumni please apply accordingly.

*School District 25 background required before acceptance

Applications are due by August 22, 2019.
Please return applications to the Pocatello-Chubbuck Chamber of Commerce at 324 South Main, Pocatello ID, 83204

Or email Attention: Rainbow Maldonado at leappocatello@gmail.com

Any questions please call the Chamber at 1-208-233-1525 or Rainbow Maldonado directly at 1-208-241-7269.
Applications may also be mailed to PO Box 626, Pocatello ID 83204

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Street Address *

City, State *

Zip Code *

Employer’s Information

Leadership Pocatello-Chubbuck may contact your employer to verify consent to your participation in the program.

Employer (Comany Name) *

Business Email - Applicants *

Business Phone - Applicants *

Business Address - Applicants *

Do you have full support of your employer for the required time to participate effectively in the LEAP Mentor program? *

Yes

Other:

Class Dates

All class dates are on Tuesdays
October 8, 2019
November 12, 2019
December 9, 2019
January 14, 2020
February 11, 2020
March 10, 2020
April 14, 2020
May 21, 2020 - Elevate Leadership Summit
LEAP Leadership Graduation- TBD May 2020

Elevate Leadership Summit

This will be included for our youth students to be invited to attend this summit on May 221st 2020 as well as our mentor participation.

The Elevate Leadership Summit (ELS) increases networking and collaboration opportunities, educates professionals on leadership and development skills, and provides opportunities for innovation and implementation in your organizations. It fosters collaboration between managers and their employees, encourages the development of new ideas at all levels, and allows attendees to effectively align strategy with execution.

Organizations/Activities/Community Involvement

Please list, in order of importance to you, the major civic, business and professional activities in which you have participated during the last five years, here or elsewhere. For each activity, indicate the nature of your participation including any offices that you have held and any awards or special recognition that you have received. If you have not been involved, please explain why.

Organizations / Activities *

What do you consider your highest responsibility, skill or career achievement so far? *

Why do you want to participate in, and what do you hope to learn from LEAP Leadership Pocatello-Chubbuck? *

#1 - What three priorities would you like to see addressed for our youth in leadership in the Pocatello-Chubbuck area? *

#2 - What three priorities would you like to see addressed for our youth in leadership in the Pocatello-Chubbuck area? *

#3 - What three priorities would you like to see addressed for our youth in leadership in the Pocatello-Chubbuck area? *

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