Leadership Thurston County
Class of 2025 Application 
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First Name *
Last Name *
Employer *
Job Title *
Phone Number (format as 360.357.8515) *
Email *
Mailing Address *
Mailing City *
Mailing Zipcode *
Supervisor Name (Or Reference if owner/self-employed) *
Supervisor Phone Number (Or Reference if owner/self-employed - format as 360.357.8515) *
Supervisor Email (Or Reference if owner/self-employed) *
How long have you been with your current employer? *
How long have you lived/worked in Thurston County? *
What sector best describes your organization? *
What industry best describes your organization? (NAICS Industry) *
What best describes your position within your organization? *
I understand my answers to the following demographic questions will not affect my ability to be selected into the LTC program.  Your answers will be withheld from the selection process and only used for our program purpose to verify a representation of Thurston County demographics.  (Options are a direct correlation to TRPC reporting data to be used as a comparison of Thurston County demographics based off the latest Census.) *
How do you identify? *
Race *
Ethnicity *
Age *
Highest Level of Education *
How did you hear about Leadership Thurston County? (100 characters max) *
Our goal is to have a class with diverse perspectives, lived experiences, and personal passions.  What defines you? (250 characters max) *
Using only two words, how would you define leadership? *
In one sentence, how would you define community leadership? *
How do you want to be involved in the community? *
What do you hope to gain from your LTC experience?  *
Have you participated in a community leadership program in another location?  If so, where?
I understand that the format of the Challenge Days may vary based on the Thurston County Health Department recommendation at the time of the program day.  Challenge Days may include in-person small groups, in-person full group, online via Zoom, or any combination of options as well as possible options not listed. *
LTC is made up of 11 full day (8am-5pm) challenge days.  I have reviewed the calendar and understand the time commitment to participate in LTC.  Should I be accepted into the class, I understand the 2-day Opening Retreat is required for participation and I am allowed a maximum of two program days or 18-hours of program time absence. If I accumulate more than two days or 18-hours of absence time, I understand I will not be eligible to graduate from the program. *
I understand the tuition agreement to participate in LTC ($2700).  Should I be accepted into the class, I will be invoiced  July 1, 2024.  My employer &/or myself will make payment upon the receipt of invoice and no later then August 5, 2024, unless other written agreements have been approved. *
After you submit your application, please email the Program Commitment page to ltc@thurstonchamber.com.  Your application will not be marked complete until this page is submitted.
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