With the goal of ensuring diverse and gender-balanced leadership at the helm of our region’s companies and organizations, Engage provides board-readiness training to women, subsequently helping address the current gender gap on corporate, nonprofit, and government boards and commissions across the San Diego region.

Completed applications are due by Friday, May 14.

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* 1. First Name

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* 2. Last Name

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* 3. Job Title

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* 4. Company

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* 5. Preferred Email Address

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* 6. Preferred Phone Number (include area code)

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* 7. Mailing Address

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* 8. City

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* 9. State

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* 10. Zip Code

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* 11. Were you referred by someone? If so, by whom?

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* 12. Have you previously completed a LEAD program or are a current member of the San Diego Young Leaders?

LEAD San Diego seeks a class that is reflective of the cultural diversity of the San Diego region. Accordingly, it is important to identify constituents from various demographic groups. Your responses to the following will assist our selection committee in addressing this class mix; however, your response is OPTIONAL. If appropriate, more than one box may be checked.

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* 13. I consider myself to be:

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* 14. Age

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* 15. Check the ONE category that best describes your current employer:

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* 16. In which sector do you work?

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* 17. Are you or your company a member of the San Diego Regional Chamber of Commerce?

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* 18. Have you previously served on a Board, Committee, or Commission?

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* 19. If yes, please list with which organizations/entities and the dates you served.

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* 20. I am interested in serving on a Board, Committee, or Commission for
(select all that apply)

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* 21. Why do you want to serve on a Board, Committee, or Commission?

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* 22. Are there any specific organizations or types of organizations you would like to serve?

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* 23. If yes, please list them here

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* 24. Please upload your resume

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

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* 25. Please upload your headshot

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File
 
 100% of survey complete.

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