2026 Community Builders Application

Leadership Lake County, a 501(c)(3) nonprofit founded in 1986, empowers leaders at every life stage through impactful and engaging programs.

The Community Builders program is a leadership development experience designed for front-line employees and entry-level supervisors. The program focuses on three core areas

Engagement– Fostering a supportive environment that encourages peer-to-peer learning, idea exchange, and teamwork to solve real-world leadership challenges.

Empowerment – Equipping emerging leaders with the confidence, skills, and tools to drive meaningful change in their teams and communities.

Impact – Providing practical, hands-on leadership experiences that enable participants to apply their skills immediately, inspire others, and create lasting, positive change.

Application Deadline: May 31, 2025 by 5pm. Please complete the application electronically using Google Chrome or Mozilla Firefox.

Program Fee: $995 (non-refundable), due by August 1, 2025.

Important Note: Applications are competitive, with acceptance notifications sent by June 6, 2025. Limited to 30 participants, the program’s costs are allocated per individual.

If you are unable to participate after submitting an application, please notify Juliana Petti, Director of Professional Programs, at JPetti@Leadershiplc.org promptly to allow consideration of a waitlisted candidate.

First Name

Last Name

Name as it should appear on Nametag

Business Information

Business/Organization Name

Title/Position

Business Email

Business Phone

Business Address

Address Line 1

Address Line 2

City

Country

Select

State/Province

Select

Zip Code

Personal Information

Personal Email

Mobile Phone

Home Address

Address Line 1

Address Line 2

City

Country

Select

State/Province

Select

Zip Code

Spouse/Partner First and Last Name

Birthdate (mm/dd/yyyy)

Dietary Restrictions - Please note any restrictions/allergies

Demographic Information (for internal use only)

Sex

Select Gender

Female
Male
Trans
Prefer not to answer

Ethnicity

Select One

White
Asian
African American
Hispanic-Latino
Native American
Bi-Racial
Other

Your Goals for the Program

Your Program Goals

What are three (3) goals you aim to achieve through your participation in this program?

Education/Training

Name of High School

Graduation Year

Name of College or Educational Institution

Degree/Major or Certification

Name of College or Educational Institution

Degree/Major or Certification

Military Service

Military Service - Branch/Dates

Civic Engagement

Major volunteer roles at this time. Please include leadership positions where applicable.

Community Organizations/Nonprofits I am interested in serving

Employment History

Previous Employer Name/City

Dates/Title/Responsibility

Previous Employer Name/City

Dates/Title/Responsibility

Participation

Community Builders participation includes:

*Orientation I Overview of Leadership Lake County: August 18, 2025 from 4pm-5pm followed by a reception with our Board of Director and Alumni from 5pm-6:30pm
*Opening Retreat I What is Leadership? : September 8, 2025 9am-4:30pm
Diagnose the Situation I Program Day: October 6, 2025 12pm-5pm
Diagnose the Situation II Day: November 3, 2025 12pm-5pm
Manage Self I: December 8, 2025 12pm-5pm *Please note this is the second Monday due to Thanksgiving Holiday
Manage Self II: January 26, 2026 12pm-5pm *Please note this is the last Monday due to the holiday season
Energize Others I: February 9, 2026 12pm-5pm
Energize Others II: March 2, 2026 12pm-5pm
Intervene Skillfully: April 6, 2026 12pm-5pm
*Closing Retreat: May 4, 2026 9am-4pm
*Graduation: June 3, 2026 from 6pm-9pm

*Mandatory attendance required. We ask for 80% attendance overall to be eligibale for graduation.

Questions about participation? Reach out to Juliana Petti, Director of Professional Programs JPetti@leadershiplc.org.

Time Commitment

Will you be able to fulfill this time commitment?

YES
NO

Employer/Family Support

Do you have the full support of your employer/family for the time required to participate effectively in this program?

YES
NO

Program Cost

The program cost is $995 per participant, which covers all retreats, all program meals, transportation, materials, and a $50 non-refundable application fee. If selected, the $50 application fee will be applied toward the $995 program cost. If waitlisted, your application may be reconsidered upon request without incurring an additional fee. No other direct program expenses are anticipated. The $995 program fee is non-refundable and due by August 1, 2025.

How will your tuition be paid?

Employer
Personal

Program Referral

Referred to Program by:

Program Commitment

I understand that submitting this application does not guarantee acceptance into the Leadership Lake County Signature class. If selected, I commit to dedicating the necessary time to fulfill all program requirements and to paying the program fee in full. By entering my name in the box below, I certify this as my authorized signature for the application.

Applications are highly competitive, with acceptance notifications sent by June 6, 2025. As only 30 spots are available, program costs are allocated per participant.

If you are unable to participate after submitting the application, please notify Juliana Petti, Director of Professional Programs, at JPetti@Leadershiplc.org promptly to allow consideration of a waitlisted candidate.

First Name

Last Name

Date

Application Fee

Please note the $50 application fee is non-refundable. If selected, the $50 application fee will be applied toward the $995 program cost. If waitlisted, your application may be reconsidered upon request without incurring an additional fee.

Billing Address

Address Line 1

Address Line 2

City

Country

Select

State/Province

Select

Zip Code

Sub Total

$50.00

TOTAL

$50.00

Payment Method

Credit Card

Credit Card Type

Select

Name on Card

Credit Card Number

Expiration Date

Month

Year

Verification Number

Thank you for your application! Acceptance notifications will be sent by June 6, 2025.

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Application Confirmation – Leadership Lake County Signature Class of 2026

Thank you for submitting your application for the Leadership Lake County Signature Class of 2026. Applications are competitive, and acceptance notifications will be sent by June 6, 2025. With only 45 spots available, program costs are allocated per participant.

If you are unable to participate after submitting your application, please promptly notify Juliana Petti, Director of Professional Programs, at JPetti@Leadershiplc.org to allow consideration of a waitlisted candidate.

Thank you,

The Leadership Lake County Team

View Submission