Leadership St. Louis Application Form

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If you experience any issues with your form submission, please contact Becky Rasmussen at beckyr@focus-stl.org. We also encourage you to save your submission by clicking Save and Continue at the bottom (be sure to enter your email address) before doing your final submission.

Leadership St. Louis 2024-25 Application

"*" indicates required fields

Two recommendations are also required. A link to the recommendation form will be emailed to you upon your application submission, or you can access the form here.

Name*

First Last

Preferred Name

Email*

Title/Position

Employer/Organization

Preferred Mailing Address

Home

Work

Home Address

Street Address Address Line 2 City State ZIP Code

Work Address

Street Address Address Line 2 City State ZIP Code

Preferred Phone Number

Phone Type

Home

Mobile

Work

Number of Years in the St. Louis region

Are you a graduate of a FOCUS St. Louis program?

Yes

If yes, which program(s)?

Emerging Leaders

Women In Leadership

Youth Leadership St. Louis

Experience St. Louis

Other

Demographics

The following questions help us to measure the diversity of our class and our outreach efforts.

Date of Birth (in month/day/year format)

MM slash DD slash YYYY

Age

Gender

Female

Male

Non-Binary

Prefer not to say

Other

Which categories describe you?

Select all that apply.

American Indian or Alaska Native

Asian

Black or African American

Hispanic, Latino or Spanish origin

Middle Eastern or North African

Multi-Racial

Native Hawaiian or Pacific Islander

White/Caucasian

Some other race, ethnicity or origin

If other, please specify:

Select county of residence.

Employment

In which sector do you work?

Business/Corporate

Education

Entrepreneur

Government/Public Service

Health Care

Labor

Legal

Nonprofit

Volunteer

Other

Describe your current major job responsibilities.

Number of years with current employer.

Please list your previous employment.

I. Dates - To/From

I. Title/Position

I. Employer

I. Major Responsibilities

II. Dates - To/From

II. Title/Position

II. Employer

II. Major Responsibilities

III. Dates - To/From

III. Title/Position

III. Employer

III. Major Responsibilities

In terms of your career, where do you hope to be in five years?

Education

Degrees/Certifications

Personal Perspective

What specific skills, knowledge or experience would you bring to this class of Leadership St. Louis?

What personal or professional outcomes are you hoping to achieve through participation?

How would you use your Leadership St. Louis experience in your community and profession?

Community/Civic Involvement

Please list no more than 5 civic organizations that you are or have been a part of, including dates.

What do you consider to be your highest level of responsibility or greatest achievement to date?

Which of these do you consider to be your single greatest service to the community? Why?

How did you hear about Leadership St. Louis?

Yes, I'd like to receive emails about upcoming FOCUS events, civic engagement opportunities and programs.

Before hitting Submit, please review the following requirements and check that you agree to each of them.

My employer supports my participation in the 2024-25 LSL program and all program days.

I am willing to make the monthly September to May commitment for the 2024-25 LSL program.

I am aware that my absenteeism will result in my being dropped from the program.

I understand that all program fees are non-refundable.

"You basically form 60+ new friendships with a group of people who will always have your back. I have mentors and coaches who are willing to drop whatever is going on in their lives and give me time when I need it."

Johnny Wang

Leadership St. Louis 2015-16