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NEIGHBORHOODS RISING PLEASE COMPLETE THIS FORM WITH ALL (Mohawk Valley Community College)

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NEIGHBORHOODS RISING
PLEASE COMPLETE THIS FORM WITH ALL INFORMATION REQUESTED FOR EACH SECTION.
Name:
Company/Organization:
Job Title:
Home Address:
Home City:
State:
Zip:
Home Telephone:
Home E-Mail Address:
Cellular Telephone:
Work Address:
Work City:
State:
Zip:
Work Telephone:
Work E-Mail Address:
Work Fax:
For written communication, would you prefer that we use your home or work mailing address? Home Work
For electronic communication, would you prefer that we use your home or work email address? Home Work
PLEASE INCLUDE A CURRENT RESUME WITH THE SUBMISSION OF YOUR APPLICATION.
OTHER CONSIDERATIONS
Why is Neighborhoods Rising the right fit for you? What skills or knowledge do you hope to gain?
NEIGHBORHOODS RISING
Please share something about yourself that we would not learn from reading your resume and explain the impact this has
had on you as a leader:
EXPECTATIONS
Neighborhoods Rising is comprised of 8 sessions starting in February 2021.
Commitment to participating in Neighborhoods Rising centers on involvement in all class sessions. Attendance is
strongly encouraged for the sessions. Missing more than the equivalent of 2 sessions will jeopardize a participant’s
eligibility for graduation.
TUITION
The Neighborhoods Rising tuition has been generously covered by the Mele Family Fund which includes all program
related expenses.
APPLICANT AGREEMENT
I have read and understand the commitments required of Neighborhoods Rising. I am willing to attend all required
sessions/functions of the Center for Leadership Excellence/Neighborhoods Rising and devote the time necessary to be a
contributing member of the class. I understand that if I fail to meet these obligations I will not be permitted to graduate
from Neighborhoods Rising and will not receive a refund of my tuition.
Applicant Signature Date
Please check each box to ensure application includes:
complete form all appropriate signatures updated resume
Return Application to:
cle@mvcc.edu
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NEIGHBORHOODS RISING PLEASE COMPLETE THIS FORM WITH ALL (Mohawk Valley Community College)

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Completed 3 February 2021

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