I am applying for Leadership II Series *

Date of completion of Leadership I? *

How many times have you previously applied? *

GRPA District *

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Name *

Gender *

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Email *

Phone *

T-Shirt Size *

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S

M

L

XL

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XXXL

Home Address *

Present Employer *

Business Address *

Present Title or Position *

Brief Description of Job Responsibilities *

Direct Supervisors Name *

Contact Number *

GRPA or Professional Affiliations and Service Organization Activities *

Name of Group *	Position Held or Assignment *	Period of Affiliations *
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Employment History *

List present position first

Employer *	Title *	Period of Service *
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List community activities that you have or are currently participating in: *

List in order of importance

Describe a mentor, coach, or leader who influenced your approach to team leadership. *

What did you learn from them, and how do you apply it today? 

Which supporting skills do you think are most important when it comes to leadership? *

Describe a time you faced a challenge while working on a team and how did you handle it? *

Tell a takeaway you had from Leadership I, and how did you use it in your work life? *

Describe a time you helped a colleague or team member grow in their role. *

What do you consider the biggest challenge in leading a team in the parks & rec field today? *

How would you address it?

Check Box: *

If selected, I agree to attend all 3 days at Rock Eagle.

Check Box: *

If selected, I agree to serve and help with the Silent Auction Committee leading up to and during the GRPA Annual Conference this year.

Agency Director Acknowledgement *

My director fully supports me to attend the George Harris Leadership Series applied for, and will allow me to attend, if selected. Additionally, upon completion of the program, they will encourage me to volunteer and become involved with GRPA on the District and State Levels.