LEADERSHIP GREATER MADISON - LGM33 Application (2026/27) Survey

Thank you for your interest in applying for the 33rd cohort of Leadership Greater Madison! To submit your application, please be sure to first read the Application Guidelines at https://madisonbiz.com/lgm/ and then fill out all of the sections below.

CONFIDENTIALITY NOTICE

Please note that your application information will remain confidential until official acceptance into the program. Upon acceptance, only your primary contact information will be distributed to program presenters and other members of the class. You will be notified of any other requests to share your contact information throughout the program year.

Question Title

* 1. By signing my full name and dating below, I confirm that I have read, understand, and agree to the Leadership Greater Madison Application Guidelines and Program Code of Conduct, and that the information I provide hereafter is accurate and true.

PERSONAL INFORMATION

Question Title

* 2. First Name

Question Title

* 3. Last Name

Question Title

* 4. Preferred e-mail address (This is the address to which program communication will be sent)

Question Title

* 5. What is your home address? (street, city, zip code)

Question Title

* 6. Mobile Phone Number

Question Title

* 7. Preferred Contact Phone Number (if different from mobile number provided above)

Question Title

* 8. Date of birth

Date (MM/DD/YYYY)

Date

Question Title

* 9. What is your gender identity?

Male

Female

Non-binary

Prefer not to answer

Prefer to self-describe:

Question Title

* 10. Preferred pronouns

She/Her/Hers

He/Him/His

They/Them/Theirs

Other (please specify)

Question Title

* 11. Race

American Indian or Alaska Native

Asian or Pacific Islander

Black or African American

Hispanic or Latino

White/Caucasian

Prefer not to answer

Prefer to self-describe

Question Title

* 12. Number of years you have lived or worked in the Greater Madison region

Question Title

* 13. Special Requirements: dietary, physical or other

EDUCATIONAL BACKGROUND

Question Title

* 14. Post-Secondary School

Question Title

* 15. Graduate School - School and Area of Study

Question Title

* 16. Other Education, Training or Certification

EMPLOYMENT INFORMATION

Question Title

* 17. Current Employer (company/organization)

Question Title

* 18. Employer Address (Street, City, State, Zip)

Question Title

* 19. Your Title/Job/Role

Question Title

* 20. Length of time employed by current employer

Question Title

* 21. Name of Immediate Supervisor

Question Title

* 22. Email Address of Immediate Supervisor

Question Title

* 23. Phone Number of Immediate Supervisor

Question Title

* 24. I hereby verify that my immediate supervisor and employer has received the mandatory dates of LGM33 and supports my participation in the program.
Please sign and date below to confirm the above statement.

Question Title

* 25. Previous employers since 2020, if any

PROFESSIONAL & COMMUNITY ENGAGEMENT

Question Title

* 26. Please list all business and/or professional affiliations. Include name of organization(s), position(s) held, and period of affiliation.

Question Title

* 27. Please list all community involvement here (community, civic, religious, political, social, athletic, or other activities). Include name of organization(s), position(s) held, and period of affiliation.

If you have not been actively involved in the community, tell us what conditions may have changed that now enable you to seek opportunities for greater involvement (like LGM).

NOMINATOR INFORMATION

Question Title

* 28. Name of Nominator
If you are self-nominating, please write "Self-Nomination" and skip to question 33.

Question Title

* 29. Relationship to Nominee

Question Title

* 30. Nominator Employer and Role

Question Title

* 31. Nominator Email Address

Question Title

* 32. Nominator Contact Phone Number

Question Title

* 33. Which best describes your sponsoring organization/employer?

For-profit business

Nonprofit organization (501c3)

Educational institution

Governmental agency

Self-employed

Other - Please describe

Question Title

* 34. Tuition is typically paid by participants' employers or self-funded by the participant. To help ensure leaders from a variety of backgrounds and organizations can participate, a limited amount of scholarship assistance may be available.

Would you require scholarship assistance in order to participate in Leadership Greater Madison?

Yes

If yes, please briefly describe your circumstances and what level of assistance would be necessary. We will follow up individually after reviewing applications to discuss further.

Question Title

* 35. How did you learn about LGM?

ESSAY QUESTIONS

Please share your answer to the following questions in no more than 250 words per question.

Question Title

* 36. Describe an issue affecting the Greater Madison community that you have directly observed or experienced. What have you noticed about its impact, and why does it matter?

Question Title

* 37. We strive to develop a diverse class that is comprised of a variety of leaders. Please describe what makes you a compelling candidate for LGM and tell us why you want to participate in the program. Consider how your unique blend of personality, skills, perspectives, and experiences - both professionally and in the community - would make you an asset to the program and the LGM33 cohort.

Question Title

* 38. What do you hope to gain from the LGM experience, and how do you envision using that experience to strengthen your leadership and contribute to the Greater Madison community?

Question Title

* 39. Is there anything else you would like us to know about you as we review your application?
(Optional: This is an opportunity to share something that adds context, depth, or a different perspective to your application.)

LEADERSHIP GREATER MADISON - LGM33 Application (2026/27)

Question Title

* 1. By signing my full name and dating below, I confirm that I have read, understand, and agree to the Leadership Greater Madison Application Guidelines and Program Code of Conduct, and that the information I provide hereafter is accurate and true.

Question Title

* 2. First Name

Question Title

* 3. Last Name

Question Title

* 4. Preferred e-mail address (This is the address to which program communication will be sent)

Question Title

* 5. What is your home address? (street, city, zip code)

Question Title

* 6. Mobile Phone Number

Question Title

* 7. Preferred Contact Phone Number (if different from mobile number provided above)

Question Title

* 8. Date of birth

Question Title

* 9. What is your gender identity?

Question Title

* 10. Preferred pronouns

Question Title

* 11. Race

Question Title

* 12. Number of years you have lived or worked in the Greater Madison region

Question Title

* 13. Special Requirements: dietary, physical or other

Question Title

* 14. Post-Secondary School

Question Title

* 15. Graduate School - School and Area of Study

Question Title

* 16. Other Education, Training or Certification

Question Title

* 17. Current Employer (company/organization)

Question Title

* 18. Employer Address (Street, City, State, Zip)

Question Title

* 19. Your Title/Job/Role

Question Title

* 20. Length of time employed by current employer

Question Title

* 21. Name of Immediate Supervisor

Question Title

* 22. Email Address of Immediate Supervisor

Question Title

* 23. Phone Number of Immediate Supervisor

Question Title

* 24. I hereby verify that my immediate supervisor and employer has received the mandatory dates of LGM33 and supports my participation in the program.Please sign and date below to confirm the above statement.

Question Title

* 25. Previous employers since 2020, if any

Question Title

* 26. Please list all business and/or professional affiliations. Include name of organization(s), position(s) held, and period of affiliation.

Question Title

Question Title

* 28. Name of Nominator If you are self-nominating, please write "Self-Nomination" and skip to question 33.

Question Title

* 29. Relationship to Nominee

Question Title

* 30. Nominator Employer and Role

Question Title

* 31. Nominator Email Address

Question Title

* 32. Nominator Contact Phone Number

Question Title

* 33. Which best describes your sponsoring organization/employer?

Question Title

Question Title

* 35. How did you learn about LGM?

Question Title

* 36. Describe an issue affecting the Greater Madison community that you have directly observed or experienced. What have you noticed about its impact, and why does it matter?

Question Title

Question Title

* 38. What do you hope to gain from the LGM experience, and how do you envision using that experience to strengthen your leadership and contribute to the Greater Madison community?

Question Title

* 39. Is there anything else you would like us to know about you as we review your application?(Optional: This is an opportunity to share something that adds context, depth, or a different perspective to your application.)

* 24. I hereby verify that my immediate supervisor and employer has received the mandatory dates of LGM33 and supports my participation in the program.
Please sign and date below to confirm the above statement.

* 28. Name of Nominator
If you are self-nominating, please write "Self-Nomination" and skip to question 33.

* 39. Is there anything else you would like us to know about you as we review your application?
(Optional: This is an opportunity to share something that adds context, depth, or a different perspective to your application.)