Leadership Summit 2023 - Official Application
COURSE DATES:  January 7-13, 2023 
LOCATION:  Glen Eyrie, Colorado Springs, CO

PLEASE NOTE:  The application is a THREE STEP PROCESS.

STEP ONE (Online)
Complete AND SUBMIT this online application form.

STEP TWO
Pay the deposit online.

STEP THREE
Complete the Release Packet. You may pick up a packet from the Lytle Center (MBB 255 in COBA).

Only after ALL STEPS have been completed is your spot reserved for Leadership Summit 2023.

Our office will register you for BUSA 435: Christian Leadership Perspectives once your application has been fully processed. Tuition costs are covered by block tuition but the program fee will be charged to your student account (minus your deposit) on your Spring 2023 bill. Students may audit the course for $35 but program fees still apply.

Program Fee:  $850 (includes all lodging, meals, speaker sessions, and activities)

IMPORTANT DEADLINES TO REMEMBER
October 20th:  $850 Regular Program Fee Deadline
October 21st - October 31st:  Closing Rate Application Deadline (Program Fee: $899)
Full Program Fee reimbursement - on or before December 15, 2022
Full Tuition reimbursement - January 6, 2023
No Shows will be billed full Program Fee.
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APPLICANT'S INFORMATION
Were you a Summit student last year?
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First Name *
Last Name *
Banner # (Please be sure you type in your 9-digit number correctly) *
Please verify your Banner # by typing it in once more (Be sure that your Banner # is correct) *
Cell Phone *
Email *
Address *
City *
State *
Zip Code *
Classification *
Major *
GPA *
Will you be taking the Leadership Summit course (BUSA 435) for credit, or auditing? *
What is your T-shirt size? *
Gender *
Emergency Contact Information
First Name *
Last Name *
Relationship *
Cell Phone *
Home Phone *
Email *
Address *
City *
State *
Zip Code *
HEALTH INSURANCE INFORMATION
Insurance Company *
Name of Policy Holder *
Policy Number *
Insurance Company Address *
SPECIAL CONSIDERATIONS
Summit will include several outdoor, active leadership development activities.
Please keep this in mind when answering the following medical questions.
List any health related accommodations or other special needs that we should know about *
Fill in N/A if nothing
What specific dietary needs (if any) do you have? (while we try to accommodate as many needs as possible, sometimes we cannot but will communicate this to you if we are not able to)
Deposit: 

Your next step is to initiate your online deposit of $50 at the link below.   
Deposit link:
Do You have Significant Financial Need?

For students who find the Summit program fee to be a significant burden, we encourage you to apply for a scholarship that may be able to offset a portion of the expense.  Applications are reviewed by an independent committee and awards are given based on need and motivation.  

Thank you for completing this part of the application process.

REMINDER:  YOUR SPOT for Leadership Summit will ONLY BE RESERVED when ALL of the applications forms have been completed.    

Any questions?  You may contact the Lytle Center at lytlecenter@acu.edu or speak with one of the Lytle Center Student Leaders in Mabee Business Building 255.
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