Event Description Personal Data
Present Employer: Date of Hire:
Work Phone #: Cell Phone #:
Emergency Contact: Email:
General Information: What strengths would you bring to Building Belgrade?
What do you think is the area’s most notable opportunity?
What do you think is a significant challenge facing the Belgrade area today?
What are your ideas for addressing this challenge?
Tuition Tuition for Belgrade Chamber Members is $325, non-Chamber members is $425. Tuition is non-refundable and due to the Belgrade Chamber by July 21, 2017 Who is responsible for your tuition? _____Employer ________ Self Candidate: Attendance at all sessions is top priority. Retreat and Graduation class sessions attendance is mandatory. I understand the purpose of Building Belgrade and if I am selected, I will devote the time and resources necessary to complete the program. I understand the above commitments and agree to uphold them to the best of my abilities. Applicant Name (print) _____________________Signature_________________________ Date:________ Employer– This application has the approval of this organization and the candidate has our full support, which includes the time required to participate in this program Employers Name (print)____________________Signature__________________________Date_________