Application Form

Applicants must submit at least two (2) personal recommendations from people who are knowledgeable about your leadership performance or potential. The best applications will have recommendations from different organizations. Please limit recommendations from Leadership Rockland board of directors to one. (See list at http://www.leadershiprockland.org/about/board-of-directors/.)

Please provide the names and email addresses of the two people you have asked to provide a recommendation. Please advise your references that Leadership Rockland will email them the recommendation link directly.

Payment of the application fee can be made online (preferred method). Payment can also be made by check payable to Leadership Rockland, Inc. Please indicate below which payment method you intend to use. After you submit your completed application, you will receive further details on paying the application fee.

If you are willing to make a commitment to attend each of the 11 sessions from September through June, and you understand the tuition requirements, please so indicate with your signature. By signing you understand that you are committing to the terms of the program participation. By checking this box each party agrees that the electronic signatures, whether digital or encrypted, of the Applicant submitting this Application are intended to authenticate this writing and to have the same force and effect as manual signatures.

Once you submit the form, you will be redirected to our payment page where you can pay your application fee.