2016-2017 PACE Application

Please review the application and prepare your answers before starting.

There is no "save" feature.

* Name

* Street Address

* City

* Zip

Home or Cell Phone

Work Phone

* Email

* 1) Please describe your past and present involvement in your community.

(max 300 words)

* 2)Please tell us about yourself and what influences your desire to be a leader?

(max 300 words)

3) What three skills would you most like to acquire or improve from participating in this academy?

(max 300 words)

* 4) As an emerging leader, what skills would you like to share with the other PACE participants during the sessions?

(max 300 words)

(please provide the name of a personal or professional reference)

Name

Home Phone

Work Phone

Email Address

When finished with the application please make sure to click SUBMIT below. You will receive a receipt of your submittal within 3 business days.

A limited supply of COVID-19 vaccinations is available!