Leadership Charlotte Transfer Application

Membership in Leadership Charlotte shall be open to persons who have completed city leadership programs of similar structure and length which are affiliated with the Association of Leadership Programs (ALP) and who have met the following criteria:

ENCOUNTER Charlotte (Fall Session)
Paid an audit fee which shall be equal to 25% of the prevailing Leadership Charlotte tuition
Submitted written verification of graduation from a leadership program in another city
Submitted a written application and photo (a basic information form, so that we might have some background history on file)

Persons meeting these criteria will be regarded as full members of Leadership Charlotte, entitled to all rights and privileges of same.

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* 1. Name

First Name

Last Name

Prefer to be called

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* 2. Headshot

Please upload your photo here.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

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* 3. Leadership Program Information

Graduate of what Leadership Program *

City

State *

Year *

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* 4. Date of Birth (Month/Day/Year)

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* 5. Gender

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* 6. Race/Ethnicity

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* 7. Current Employer Information

Employer/Title

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 8. Home Contact Information

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 9. Preferred Mailing Address

Work

Home

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* 10. Preferred Email Address

Work

Home

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* 11. Emergency Medical Contact Person

Name *

Relationship to you *

Mobile Phone Number

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* 12. Education

College/University

State

Degree

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* 13. Previous Employment

Employer

Title

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* 14. Special Awards/Honors Received

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* 15. Why are you wishing to transfer into Leadership Charlotte?

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* 16. I am interested in volunteering for Leadership Charlotte:

Alumni Committee

Marketing

Fundraising

I currently do not have time.

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* 17. Community Volunteer Interest:

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* 18. Current/Recent Volunteer Involvement:

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* 19. Charlotte Reference:

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

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* 20. Did you provide the following:

Audit Fee via PayPal (25% of current LC at-large tuition)

Written Verification of Program Completion

Photo/Headshot

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* 21. Signature (this serves as my electronic signature)

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