Leadership San Ramon Valley | Participant Application for the Class of 2027

Personal Information

First Name *

Last Name *

Cell Phone *

Home Address *

Home City *

Home Zip *

Personal Email *

Why are you interested in participating in the Leadership SRV program?

Employment Information

If currently employed

Employer

Work Phone

Work Email

Work Address

Work City

Work Zip

Briefly describe your role/responsibilities

Community Involvement

Participation in community, civic, professional, and other organizations (1-3 most important to you)

Organization Name

Describe your involvement

Organization Name

Describe your involvement

Organization Name

Describe your involvement

Time Commitment & Attendance Policy

To accomplish the program’s objectives and to realize maximum benefit, class members are expected to fully participate. Participation includes attendance at ten monthly sessions from 8 a.m. to 4:30 p.m. on the dates listed below. In addition, participants should expect from four to eight hours of outside preparation (interviews, research, group meetings, etc.) for most monthly classes. Participants who miss more than two sessions will need to make up missed sessions (beyond 2) in a subsequent year to complete the program and receive their certificate of completion. The tentative class dates for 2026-27 are listed below. They will be finalized in early June before acceptance letters and agreements are sent out.

August 20, 2026 (3rd Thursday)
September 10, 2026
October 8, 2026
November 12, 2026

December 10, 2026
January 14, 2027
February 11, 2027
March 11, 2027

April 15, 2027 (3rd Thursday)
May 13, 2027 #

# Final Class & Graduation Ceremony (later start/end time, 10am to 6:30pm)

Tuition

Local government agencies and large businesses are invoiced the full amount of $1,800 for each participant. This is based on the full cost to operate the program. To ensure inclusivity, we have set a reduced tuition fee of $1,200 for participants from community non-profits, small businesses, and individuals who pay for the program themselves. Because financial constraints should not be a barrier to participation, tuition may be paid in installments, and we also offer additional financial assistance for those who request it and demonstrate need. PLEASE DO NOT PAY FOR TUITION UNTIL AFTER YOU RECEIVE YOUR ACCEPTANCE LETTER WITH DETAILS ABOUT TUITION.

Check all that apply

I would like to request a scholarship to partially cover my tuition.

My employer will sponsor (or partially sponsor) my participation in Leadership SRV

An organization I am associated with will sponsor (or partially sponsor) my participation in Leadership SRV. Name of organization:An organization I am associated with will sponsor (or partially sponsor) my participation in Leadership SRV. Name of organization:

Check if the sponsoring employer or organization is a non-profit

Reference Section

Please identify one person who has recommended that you participate in the program. Alternatively, please provide one reference.

Reference's Full Name

Reference's phone and/or email

At which email address do you prefer to be contacted for class communications?

Class material often includes attachments. If your work email typically blocks attachments, please consider choosing "personal" or "both."

Radio Buttons

Personal email address

Work email address

Both

Submission

Please submit your application by June 2.
Email or call for more information or with questions. Acceptance Agreements will be emailed by the end of June.

LEADERSHIP SAN RAMON VALLEY
Email: leadershipsrv@gmail.com
Google Voice: 925.272-8553
Post Office Box 1185, Danville, CA 94526
www.leadershipsrv.org

Please send me a copy of my submission. *

Yes

No

Captcha