Leadership Sullivan - 2025-2026 Class Program Application

PROGRAM REQUIREMENTS
Participation in the Leadership Sullivan program requires a commitment to the following:
• Mandatory Overnight Retreat: Begins the morning of September 15 and ends the afternoon of September 16
• One Full Day Session per Month: Sessions run from September through June
• Time Commitment: 8 to 10 hours per month, including session attendance and preparation
• Class Project: Participation required. Additional time may be needed for planning and group collaboration
• Graduation Banquet: Evening event held in June
• Attendance Policy: Total absences may not exceed 12 hours without written approval

SUPPORT SPONSORSHIPS AVAILABLE
If you are in need of tuition assistance, support sponsorships are available for participants with demonstrated financial need.

To apply, please include a separate statement outlining your request for assistance and financial need.

For any questions, contact the Sullivan County Chamber Office at 845-791-4200 x3.

First & Last Name

First Name *

Last Name *

Home Mailing Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Phone Number *

Business Name *

Job Title *

Business Mailing Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Business Phone (If different from personal mobile number)

Business Email *

Supervisor's Name *

Are you self employed? *

Yes No

Please indicate which primary contact information you would like to use throughout the year for class communication, check all that apply: *

Personal Phone Personal Email Address Business Phone Business Email Text to Personal Cell Phone*

Resume Upload *

Please upload your most recent resume in PDF or Word format

Tell Us About Yourself *

In 5-10 sentences, share a brief bio including your current role, background, and what you're passionate about. This may be used in participant introductions or program materials.

Describe one Sullivan County topic area you would like to learn more about: *

What do you consider the most pressing issue facing Sullivan County today, and why? *

What do you hope to gain from the Leadership Sullivan program? *

Briefly share what you’re hoping to learn, experience, or achieve by participating in the program. This helps us better understand your goals and how to support your growth.

LinkedIn Profile (Optional)

If you have a LinkedIn profile, please share the link here. This helps us get to know your professional background and connect with you online.

Leadership Sullivan - 2025-2026 Class Program Application

Thank You to our Wonderful Sponsors!

Chamber Crusaders

Chamber Champions

Media Sponsors

Chamber Advocates

Sullivan County Chamber of Commerce & Industry, Inc.