LSET Class of 2023 Application (new)
Please complete the following form to apply for the LSET Class of 2023.
Thank you,
Maris Peno
Program Director
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Last Name *
First Name *
Middle Initial *
Preferred Name *
Salutation *
Residential Address (Street Address) *
City of Residential Address *
Zip Code of Residential Address *
County of Residential Address *
Home or Cell Phone Number *
Personal Email Address *
Length of residency in Southeast Texas *
Name of Company/Organization *
Business Mailing Address (Street Address) *
City of Business Address *
Zip Code of Business Address *
County of Business Address *
Business Phone Number *
Business Email Address *
Your Position or Title Within Your Company or Organization *
Describe your employment responsibilities, type of organization and length of employment: *
Are you currently an elected public official? *
Are you a candidate, as a public official, for election or re-election (even if unopposed)any time from September 2022 - May 2023? *
Please list any relevant education and training opportunities that you have completed or are currently pursuing. (Including University, College, Certifications, Apprenticeships, Other leadership programs, etc) *
Please list any recognitions, honors and awards that you have received. Be sure to include the organization, location, estimated date and a short description. *
Please list and civic, professional, religious, social, athletic or other organizations in which you have been or are a member. Include the organization, dates of affiliation and leadership positions. *
I have read the nomination guidelines on the LSET website and understand the time and tuition requirements of the Leadership Southeast Texas program and am prepared to fulfill these requirements. *
My supervisor has been notified of the time commitment of the LSET program and supports my registration. *
How did you hear about LSET or who encouraged you to apply? *
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