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Are you ready to grow a leader within your organization? Fill out the below application to be considered for our next kickoff in August.
If you have questions about the program please email
Jill Ackerman
or call 319-377-6316.
MLIA Program Details
MLIA Application
Personal Information:
*
Indicates required field
Name
*
First
Last
Phonetic pronunciation of name
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Employment:
Current Employer
*
Phone Number
*
Email
*
Business Mailing Address
*
Line 1
Line 2
City
State
Zip Code
Country
Type of Business
*
Years of Employment
*
Title/Position
*
Briefly describe your responsibilities
*
General Information:
What are you hoping to gain from MLIA?
*
What organizations are you already involved in? List positions and responsibilities:
*
Employer Authorization:
I have provided program information and received approval from my employer to participate in the MLIA program. I and/or my employer agree to the time and financial commitments required to participate in the program.
*
Yes
No
Name of Supervisor
*
Title/Position
*
Application Agreement:
By checking "yes", I agree to fulfill the MLIA course requirements which are session attendance, elective completion and participation and participation in the group project. By checking yes, I understand the $500 ($600 for non-members) is due upon receipt. I also understand that I am personally responsible for any portion of the fee not paid by my employer, and that the fee is non-refundable.
*
Yes
No
Resume and Professional Headshot
Please attach the following documents below:
Resume
*
Max file size: 20MB
Professional Headshot
*
Max file size: 20MB
Payment:
Please send invoice to:
*
Line 1
Line 2
City
State
Zip Code
Country
Attn:
*
Submit
About
Board of Directors
Our Team
Community Initiatives
Our Partners
Community Impact Award
>
Community Impact Award Nominations
Marion Chamber Foundation
Events
Chamber Event Calendar
Community Calendar
Chamber Golf Outing
Annual Meeting
Oktoberfest
Uptown Marion Markets
>
Vendor Information
Uptown Getdown
Chocolate Walk
Christmas In The Park
Submit an Event
News
Member News
Submit a Press Release
Directory
Resources
Business Support
>
Small Business Revolving Loan Fund
Business Networking
Ambassadors
Shop Where I Live
Professional Development
>
Leadership in Action
>
MLIA Application
MLIA WInter Lights Project
Marion Business Academy
Membership
Join the Chamber
Welcome
Welcome Center
Why Marion?
Member Login