Applicant Information

Full Name

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* 1. Full Name

Cell Phone

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* 2. Cell Phone

Email

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* 3. Email

What is the Zip Code of city you live in?

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* 4. What is the Zip Code of city you live in?

What is the name of city you live in?

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* 5. What is the name of city you live in?

How many years have you lived in your CURRENT City?

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* 6. How many years have you lived in your CURRENT City?

Union Membership:

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* 7. Union Membership:

Union Sponsor:

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* 8. Union Sponsor:

Do you currently hold or have you previously held public office(s)? If yes, what public office(s) do you / or have you held and when?

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* 9. Do you currently hold or have you previously held public office(s)? If yes, what public office(s) do you / or have you held and when?

Have you ever been before the COPE board? If yes, what was the outcome?

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* 10. Have you ever been before the COPE board? If yes, what was the outcome?

What is your job classification?

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* 11. What is your job classification?

How long have you been a union member?

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* 12. How long have you been a union member?

Which unions have you belonged to? Please list all.

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* 13. Which unions have you belonged to? Please list all.

Briefly summarize your work within your union. (250 word limit)

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* 14. Briefly summarize your work within your union. (250 word limit)

Have you considered holding appointed or elective office before? If so, what have you considered?

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* 15. Have you considered holding appointed or elective office before? If so, what have you considered?

Briefly summarize your personal background; work experience, education, community involvement, etc. (250 word limit)

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* 16. Briefly summarize your personal background; work experience, education, community involvement, etc. (250 word limit)

Please summarize why you are interested in the LA Fed Civic Leadership Academy, and what you hope to gain from it. (400 word limit)

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* 17. Please summarize why you are interested in the LA Fed Civic Leadership Academy, and what you hope to gain from it. (400 word limit)

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