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* 1. First Name

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* 2. Last Name

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* 3. Date of Birth

Date

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* 4. Phone

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* 5. Address Where You Are Registered to Vote

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* 6. Length of Time at Current Address

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* 7. Current Employer

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* 8. Title

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* 9. Email

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* 10. Registered Political Affiliation

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* 11. What area of public leadership interests you most?

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* 12. PLI is a program for pro-business aspiring public leaders. Please make the case for why you should be admitted to PLI and what being pro-business means to you.

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* 13. Please describe what you view as the most important public policy issue or issues facing the business community in San Diego and how your experience could be used to address these issues.

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* 14. What is your time table for exploring candidacy or an appointment to a board or commission? Do you have a particular office or board in mind?

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* 15. What specifically do you hope to learn in this program?

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* 16. If you have ever run for office or worked/volunteered as a staff member on a campaign, please list them below.

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* 17. How did you hear about PLI?

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* 18. If there is any other information you would like to share with the selection committee, particularly as it demonstrates your commitment to public service, community engagement, and leadership, please do so below. Note: admittance into PLI does not guarantee a future candidate endorsement or support from program sponsors.

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* 19. Upload your resume

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