Class of 2020 Application Form

General Information

Selection into the program is based upon having a cohort that is balanced in terms of level of experience, professions, agencies/businesses, and community sectors;  submission of this application does not guarantee acceptance into the program.

By completing and signing this application, participants agree to the following:

1.  To notify the program director in advance of an absence and that one absence is allowed. This
     absence may be made up during the following year's training program with approval of the
     program director.

2.  If absent, the participant will contact the program director or a fellow class member to obtain
     information shared at the missed training day.

3.  Participants agree to meet the time and program requirements, which include confidentiality of any personal or professional information shared during the program.

4. Participants have the approval of their supervisor for attendance for the entire program as well as their agency’s or business to cover the tuition cost.

5. As some agencies require supplemental documentation in addition to the tuition invoice, participants will notify the LEB program director if any of these documents are required.

6. Tuition payments will be paid within 30 of receipt of an invoice from LEB.

Applications

Applications may be submitted online or mailed to LEB at:

          LEB - 1442 A Walnut Street, #438 - Berkeley, CA 94709

If submitted online, completion of the signature lines as an e-signature by employer and employee constitutes a valid agreement with LEB.  

Tuition & payment

Cost is $1,500/participant. Tuition includes retreat, class materials, continental breakfasts and lunches, and snacks on LEB Friday training days.

The program director will invoice the participant or his/her designated agency staff person upon acceptance into the program.

Payment can be make by credit card or check. The tuition invoice will include a link to our payment processor. Tuition checks should be made out to Social Good Fund (our fiscal sponsor) and include a notation with the name of the participant and memo line notation of "for LEB program" and addressed and mailed directly to Leadership East Bay at:

         LEB - 1442 A Walnut Street, #438 - Berkeley, CA 94709

Pay Online

Name *
Name
Phone
Phone
Name 1
Name 1
Address
Address
Employer Name & Title
Employer Name & Title