Leadership Palestine Registration 2026

ATTENDEE INFORMATION

First Name *

Last Name *

Home Mailing Address

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

E-mail (this will be used to contact you and throughout the program for communication) *

Cell Phone Number *

City of Birth *

T-Shirt Size *

S M L XL XXL XXXL

Your exact name as you would want it on a name tag *

Number of years as resident in Anderson County *

BUSINESS/ EMPLOYER INFORMATION

Business/ Employer Name *

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Office Phone Number *

How long have you been with this business? *

Your title as you would want it published or broadcast *

Do you have the full support of your employer for the time required to participate effectively each month in the Leadership Palestine Program? *

Yes No

Does your working schedule permit time during "office hours" to attend all sessions of the Leadership Palestine Program? *

Yes No

Do you understand the Leadership Palestine Program Attendance Policy and that 3 (three) absences will prevent you from graduating, regardless of excuse? *

Yes No

I became interested in the Leadership Palestine Program through ...... *

What do you hope to gain from participation in the Leadership Palestine Program? *

ATTENDANCE

A. Leadership Palestine team will do everything possible to abide by the tentative schedule presented. However, on occasion schedule changes may become necessary. Attendees will be informed in a timely manner. B. This program requires a monthly time commitment for 10 months; we ask that you have full support from your employer before application submission. C. If you are unable to attend a monthly meeting, notification must be made 48 hours in advance by contacting the program coordinator, Angela Howell-Fields via text or e-mail (angela@palestinechamber.org). D. An e-mail will be sent to the attendee as well as their employer after a session has been missed. E. Any person missing three sessions or more of the Leadership Palestine Program will not receive a graduation certificate. No exceptions will be made. F. Tuition is non-refundable after the first session of the program.

ACKNOWLEDGMENT *

By typing my full name here and submitting this application, I acknowledge that I am applying for this program with the understanding that it requires dedication and responsibility. I agree to: a. Participate for the full length of the program. b. Attend each monthly meeting in its entirety, unless I have notified the program director prior. c. Dedicate the necessary time to fully participate. -d. Communicate at least 48 hours in advance if a conflict arises. I acknowledge that consistent attendance is essential to the success of both myself and the group, and I commit to participating for the full program term.

PALESTINE AREA CHAMBER OF COMMERCE

Leadership Palestine Registration 2026

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