Bergen LEADS Class of 2026 Application Survey

1.First and Last Name(Required.)

2.Home/Mailing Address(Required.)

3.Cell Phone(Required.)

4.Personal Email(Required.)

5.Business Email(Required.)

7.LEADS participants must live or work in Bergen County to be eligible. Please select one or both options below:(Required.)

I live in Bergen County.

I work in Bergen County.

8.Please state your current employer, if applicable.(Required.)

9.Please list your title, if applicable.(Required.)

11.How did you hear about Bergen LEADS? List the name of the person/company you were referred by, if applicable.(Required.)

12.Bergen LEADS is an opportunity for participants to learn more about the resources Bergen County can offer and to network with leaders across sectors. What do you hope to gain from these opportunities?(Required.)

13.Do you currently volunteer for any non-profits, schools, town committees, political causes, religious organizations, or other causes/organizations?(Required.)

14.How do you define "civic responsibility" and how have you demonstrated it in your life?(Required.)

15.What community role or leadership experience has been most meaningful to you and why?(Required.)

16.What challenges do you struggle with as a leader in your work or volunteer role and how do you overcome them? What areas of your leadership skills do you want to develop further?(Required.)

17.Identify a pressing issue within your community (whether that's your city, neighborhood, school, or place of employment) and explain how you would approach it through a leadership lens.(Required.)

18.Describe your communication style. How is it effective and how can it be improved?(Required.)

19.Tuition for Bergen LEADS is $2,500, is non-refundable, and must be paid by the participant, employer, or sponsoring organization. Limited scholarships are available for individuals who need tuition assistance.

Please verify that you understand there is a financial commitment for which you are responsible for fulfilling.(Required.)

I understand that I am not guaranteed a scholarship, and I am responsible for either the full $2,500 or any amount not covered by a scholarship.

I understand I am responsible for any amount that is not covered by my employer or sponsoring organization, if applicable.

By attending two more or Bergen LEADS sessions, I have committed to the program and understand that I am responsible for the non-refundable tuition.

Tuition is due up front, or a payment plan can be set up after the deposit has been made. I am responsible for adhering to the payment plan and covering the full cost of tuition by December 31, 2025.

20.Please check each box to demonstrate you understand what is expected of each Bergen LEADS member.(Required.)

Bergen LEADS meets on a weekday once per month from September to June. You must have an arrangement that allows you to attend during work hours.

Bergen LEADS requires collaboration outside of the scheduled seminar days. You will need to set aside a few hours a month to prepare for sessions and complete your team project.

Absences for emergencies are unavoidable, but participants must make a good faith effort to attend the complete session of each seminar day.

Bergen LEADS is a professional learning environment that relies on respect, collaboration, and integrity among its participants. All members are expected to uphold these standards, including punctual attendance, thoughtful engagement, and courteous communication. Acting in a manner that reflects positively on oneself and on the cohort as a whole ensures a successful and enriching experience for everyone involved.