Skip to content
Search for:
HOME
ABOUT
About AICCO
State Board Officers
Board Members
Advisory Board Members
EVENTS
Calendar
The Gathering
Gathering Sponsorship
Leadership Native Oklahoma
MEMBERSHIP
MEMBER DIRECTORY
CONTACT
LOG IN
Leadership Native Oklahoma Application Form Page
Home
→
Leadership Native Oklahoma Application Form Page
Leadership Native Oklahoma Application Form Page
Devin Lafrentz
2020-01-14T18:45:40-06:00
LEADERSHIP NATIVE OKLAHOMA CLASS OF 2022 APPLICATION
BIOGRAPHICAL INFORMATION
First Name
*
Last Name
*
Address
*
Street Address
Apt, Suite, Bldg. (optional)
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d\'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palestinian Territory
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Western Sahara
Western Samoa
Yemen
Zambia
Zimbabwe
Country
Phone
*
Email
*
Tribal Affiliation
*
OCCUPATION / VOCATION INFORMATION
Employer
*
Title
*
Employed Since
*
Business Address
*
Street Address
Apt, Suite, Bldg. (optional)
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d\'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palestinian Territory
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Western Sahara
Western Samoa
Yemen
Zambia
Zimbabwe
Country
EDUCATION
High School, Location, Year Graduated:
*
College / Location / Degree / Major:
College / Location / Degree / Major:
Additional Education (if applicable):
150 word max.
COMMUNITY INVOLVEMENT
Please list volunteer activities in which you are currently involved. If additional space is needed, please submit via email to
[email protected]
.
150 word max.
Organization & Position
Detail any responsibility:
150 word max.
Organization & Position
Detail any responsibility:
150 word max.
Organization & Position
Detail any responsibility:
150 word max.
What would you consider your most important accomplishment in one of these organizations? Why?
*
150 word max.
PROFESSIONAL / CIVIC ACTIVITIES
Please list any professional / civic organizations in which you have been active.
150 word max.
Organization & Position
Detail any responsibility:
150 word max.
Organization & Position
Detail any responsibility:
150 word max.
Organization & Position
Detail any responsibility:
150 word max.
BRIEF ESSAY
Please provide a few paragraphs of why becoming a member of Leadership Native Oklahoma would be important to you and how you believe it could benefit your career or your future as a leader.
*
150 word max.
COMMITMENT
Please initial by each statement
Enter Initials
*
To graduate from Leadership Native Oklahoma, I understand the importance of attendance at the sessions and that I am only allowed three (3) absences of these sessions.
Enter Initials
*
Sessions begin as early as 8:30am and normally before 4:00pm unless otherwise notified.
Enter Initials
*
Tuition for Leadership Native Oklahoma is $500. If accepted, your tuition is due within 15 days.
I understand the mission of the American Indian Chamber of Commerce of Oklahoma and Leadership Native Oklahoma and will devote the time necessary to optimize my participation. I will be supportive of my class and fellow class members.
Date
*
Signature
*
By typing your name you agree that you are signing this document and your name is your electronic signature.
Textarea
Textarea
TSHIRT SIZE
*
Please select a shirt size.
SMALL
MEDIUM
LARGE
X-LARGE
XX-LARGE
XXX-LARGE
Verification
Please enter any two digits
*
Example: 12
This box is for spam protection - <strong>please leave it blank</strong>:
Close product quick view
×
Title