Class XII Application
Age, gender, ethnicity and race information requested for demographic purposed only. Providing this information is voluntary had has no impact on your application status.
The two-day opening retreat for Leadership Rancho Cordova is mandatory. Both days will take place at Hampton Inn & Suites Tahoe-Truckee. Participants are also expected to attend each of the nine full-day modules and participate in a community service project with other class members requiring time outside of class.
For Leadership Rancho Cordova to accomplish its stated goals, participation is required. If you are unable to make that commitment, it is not in your best interest to apply at this time.
Failure to attend the opening retreat will result in termination from the program with no tuition refund.
Opening Retreat Dates:
Friday, October 13, 2017 9:00 a.m. to 5:00 p.m. with dinner to follow at 6:30 p.m.
Saturday, October 14, 2017 8:00 a.m. to 4:30 p.m.
Important Dates: Monday, July 31, 2017, Application Deadline Thursday, October 5, 2017, Program Reception
Module Dates * Curriculum topics may include the following: Thursday, November 09, 2017~History/Culture/Volunteerism Thursday, December 14, 2017~Local Government Thursday, January 11, 2018~Education Thursday, February 8, 2018~Leadership Thursday, March 8, 2018~Economic & Community Development Thursday, April 12, 2018~Recreation/Tourism/Art Thursday, May 10, 2018~Public Safety Thursday, June 14, 2018~Wrap-Up & Graduation *Module topics and order are subject to change
I hereby grant the Rancho Cordova Chamber of Commerce & Foundation permission to use my likeness in a photograph or video in all of its publications, including website entries, without payment or any other consideration.
I understand and agree that these materials are the property of the Rancho Cordova Chamber of Commerce & Foundation and will not be returned.
I hereby irrevocably authorize the Rancho Cordova Chamber of Commerce & Foundation to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing the Leadership Rancho Cordova program or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph.
I hereby hold harmless and release and forever discharge the Rancho Cordova Chamber of Commerce & Foundation from all claims, demands, and causes of actions which I, my heirs, representatives, executors, administrators, or any persons acting on my behalf of my estate have or may have a reason of this authorization.
I am 21 years of age or older and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning, and impact of this release.
Tuition for Leadership Rancho Cordova is $975. The full tuition amount is due by September 15, 2017, unless prior arrangements have been made.
Please make check payable to Rancho Cordova Chamber Foundation (RCCF). Major credit cards are accepted.
Refund PolicyWithdrawal from the program following confirmation to participate will result in forfeiture of tuition unless an alternate is confirmed prior to the retreat.
Sponsor Commitment Leadership Rancho Cordova nominees must have the support and commitment of their sponsoring business or organization. The signature of the head of the sponsoring organization is necessary as an indication of that support.
I understand that completion of this application does not ensure my acceptance into the Leadership Rancho Cordova program. I further understand that, if accepted, I will be required to fulfill the commitment requirements listed above. I also acknowledge that I have the full support of my employer to complete the program as described in this application.
Application Deadline: July 31, 2017, 5:00 PM
Submit by mail:Leadership Rancho Cordova Attention: Dawn S Hall2729 Prospect Park Drive, Suite 117Rancho Cordova, CA 95670
By fax:(916) 384-2046
Leadership Rancho Cordova is a project of the Rancho Cordova Chamber of Commerce Foundation and the focus is on the City of Rancho Cordova. For this reason, applicants who live or work within the City of Rancho Cordova are given preference by the selection committee.
For additional information please contract Program Administrator,Dawn S Hall at DHall@RanchoCordova.org or 916-273-5703