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APPLICATION - For LIDERAMOS Cohort 3, beginning September 2025 and ending February 2026.

APPLICATION DEADLINE: June 30, 2025 or until cohort of 25 is full.
Open to adults, ages 24 and older, as of December 2025, from all sectors in the Quad Cities and extended region who identify as Hispanic, Latino/a, Latine, Latinx, or from their related country of origin.
In applying, you are agreeing to attend and be actively involved in all LIDERAMOS QC Cohort monthly training or make-up sessions, assignments, and activities:
September 18, 2025, Thursday, 6:00 - 8:00 p.m. Welcome Reception
1. September 20, 2025, Saturday, 8:00 AM - 1:00 PM. Session 1: Retreat
All Sessions #’s 2-6 are Tuesdays at various sites – Information & Dinner 5:30pm. Instructional Portion 6pm-9:00pm
2. October 7, 2025, Tuesday. Session 2: Civic Engagement: Impacting Public Policy
3. November 11, 2025, Tuesday. Session 3: Latino Culture, Identity, and Leadership
4. December 9, 2025, Tuesday. Session 4: Approaches to Justice, Equity, Inclusion, and Belonging
5. January 13, 2026, Tuesday. Session 5: Mainstream Leadership. Mindset, Resiliency, and Mindfulness
6. February 17, 2026, Tuesday. Session 6: Maximize Your Influence through Public Communication
February 21, 2026, Saturday. Graduation – LULAC Council 10 Center, Davenport, IA

DIRECTIONS. Before you begin, feel free to visit/click https://lideramos.org/programs/lideramos-quad-cities/ to download & review detailed session descriptions. Applicants can return and finish or change their answers, only before, but not after they click 'Done' to complete the survey (use the same computer). Suggestion: Review the full survey/application and type essay responses separately then copy and paste them into your application.
CONTACT INFORMATION

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* 1. First Name:

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* 2. Middle Name:

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* 3. Last Name:

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* 4. Preferred First Name/Nickname:

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* 5. Home Street Address:

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* 6. Home City:

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* 7. Home State:

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* 8. Home Zip:

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* 9. Personal Cell Phone (For session changes or update messages):

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* 10. Work Cell Phone (For session changes or update messages):

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* 11. Personal E-mail:

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* 12. Work email:

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* 13. (for internal demographic collection) Age:

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* 14. Birth Month and Day: 00/00

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* 15. Which of the following options most closely aligns with your gender?

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* 16. Are you of Spanish, Hispanic or Latino origin or descent?

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* 17. Multi-ethnic/Other? (If yes, please specify)

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* 18. Which race best describes you? (Please choose only one.)

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* 19. Highest level of education completed?

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* 20. In which branch (or branches) of the United States military have you served? (Check all that apply)

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* 21. Name of Company or Organization of Employment:

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* 22. Work City:

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* 23. Work State:

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* 24. Work Zip Code:

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* 25. Position or Title:

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* 26. Which of the following best describes your current job level?

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* 27. What leadership skills, knowledge, and/or experience do you hope to gain during participation in LIDERAMOS QC?

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* 28. What leadership skills, knowledge, and/or experience do you hope to contribute during participation in LIDERAMOS QC?

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* 29. LEADERSHIP ACTIVITIES: Leadership exists in many forms in the community. Please list and describe leadership experiences of any kind and place, in order of importance to you, where you played an important role. You can also include committees, boards, commissions, elected or appointed positions.

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* 30. LIDERAMOS QC’s vision is an empowered and skilled Hispanic or Latino/a/x/e leadership network that advocates for the community’s needs and drives positive change.
What is your vision for your community? How can your community be improved, and what is the role you can play?

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* 31. LEADERSHIP EDUCATION COURSES OR TRAINING: In what ways have you continued to develop your leadership abilities?

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* 32. COMMITMENT TO SUPPORT INVOLVEMENT IN LIDERAMOS QC: Are you willing to attend and be actively involved in all LIDERAMOS QC Cohort attend and be actively involved in all LIDERAMOS QC Cohort six monthly training or make-up sessions, assignments, and activities? (See schedule with dates and times)

TUITION (Covers expert facilitation/speakers, books-supplies-resource materials; meals/refreshments, and special events): The LIDERAMOS QC Program fee is $1,000, payable after acceptance, in full or partial payments. Scholarships will be available according to need. You may also seek employer sponsorship. Payment from any source(s) can be made at any time, through the end of the program.

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* 33. Organization Sponsorship amount?

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* 34. Participant Payment Amount? (Everyone is required to invest in themselves, by contributing a minimum of $100 (or more if you can), regardless of scholarship or sponsorship amount received. Payable at any time before or throughout the program.)

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* 35. Scholarship available based on need. Indicate amount requested.

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* 36. In which sector do you work?

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* 37. How did you become aware of the program and/or who referred you?

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* 38. Do you have any accessibility needs?

For further information, Contact: Joe Moralez or Alfred Ramirez, at lideramosqc@gmail.com 
 

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