2024 Ascend Application

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Dear Ascend applicant,

Thank you for your interest in the Ascend Program!

Ascend is designed for emerging leaders who are equipped to serve the Round Rock community and are focused on personal, professional and leadership development.

The tuition for the Ascend Program is $600.

Complete the following application to participate in Ascend 2024. All applications are due by 5:00 p.m. on Tuesday, October 31st. Applicants accepted into the class will be notified no later than the week of November 7th.

Contact Katarina Corona, kcorona@roundrockchamber.org, with any question about the application process.

Personal Information

First name*

Last name*

Preferred name for name tag*

Preferred email*

Best contact number*

555-555-5555

Shirt size*

Gender*

Race & Ethnicity*

List any dietary restrictions

Do you currently...*

Live in Round Rock/Williamson County? Work in Round Rock/Williamson County? Live and work in Round Rock/Williamson County? None of the above.

Have you participated in Leadership Round Rock or any other city leadership programs in the past?*

Yes No

Other:

Employment Information

Current Job Title*

Company/Organization*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Is your company/organization an investor with the Round Rock Chamber?*

Yes No

Phone*

555-555-5555

Supervisor Name*

Supervisor Phone Number*

Company/Organization Website*

Supervisor Email*

Please list special awards or recognition*

Education

High School

Years

2011-2015

College/University

Degree

Major

Years

College/University

Degree

Major

Years

Short Answer

Why you are applying to the Ascend program?*

What you hope to gain from the program?*

Civic Engagement

Organization

Position/Contribution

Dates

2016-2017

Organization

Position/Contribution

Dates

2016-2017

Organization

Position/Contribution

Dates

2016-2017

Current hours per month devoted to community and/or professional organizations*

I am not currently devoted to any organizations 1-4 hours per month 5-9 hours per month 10-15 hours per month 15-20 hours per month Over 20 hours per month

If you previously have not had the time or interest in becoming involved, what conditions have changed that now enable you to seek involvement in the community?

References

Please provide contact information for three professional references.

Name*

First & Last

Phone*

555-555-5555

Length of time known*

Name*

First & Last

Phone*

555-555-5555

Length of time known*

Name*

First & Last

Phone*

555-555-5555

Length of time known*

Program Requirements

Review and confirm the following program requirements:*

Orientation is a mandatory full-day retreat on January 24, 2024. Participants are expected to attend monthly sessions (January-December). Each participant is allowed no more than 2 absences. All program dates are listed out below. Tuition is due on or before January 10, 2024. No refunds. My employer supports my participation in this program and/or I am using personal time to participate in this program.

Participants are required to attend and actively engage in subject-specific sessions, mandatory retreat, and graduation ceremony. The 2024 tentative calendar is below:

Retreat – 1/24/23
Monthly Meeting – 2/13/24
Monthly Meeting – 3/13/24
Monthly Meeting – 4/10/24
Monthly Meeting – 5/8/24

Monthly Meeting - 6/12/24
Monthly Meeting – 8/14/24
Monthly Meeting – 9/11/24
Monthly Meeting – 10/9/24
Monthly Meeting – 11/13/24
Graduation – 12/11/24*

All sessions are from 11:30 a.m. - 1:30 p.m. except for the Retreat and Graduation which will be full days. Unless otherwise noted, expect each day of the program to be an extended lunch.

Sign your name below to confirm you have read and accept the program requirements.

Signature*

[clear]

Use your mouse or finger to draw your signature above

Participants will be selected through a comparative assessment from the full complement of applications submitted for the program. The intent of this selection process is to create a group of the best candidates that represents a cross section of interest within the community. Applications must be received by 5:00 p.m. on Tuesday, October 31st, 2023.