Leadership Academy Application — Mississippi Center for Public Policy

Personal Information

First name *

Middle name

Last name *

Street address *

City *

State *

ZIP *

Email address *

Home phone

Cell phone

Professional History

Internships or employment, if applicable.

Current employer

Title / position

Job description

Professional Achievements and Highlights

If applicable.

Please describe any outstanding contributions and achievements made by you outside of school.

Educational Background

Please provide the following information about your education, including high school. List and describe any extracurricular activities. *

Civic Participation

Please describe any civic, political, or social activities — listing the organization, how you made a difference and any awards or special recognition, if applicable. *

Issue Focus

Please describe an issue important to our state and/or nation and your recommendations for a solution. *

Leadership

Why do you want to be a part of the Mississippi Leadership Academy? How will you use the skills learned for the betterment of our state? *

Future Ambition

What do you hope to achieve in the future in terms of public policy or government? *

Reference

Details of the person writing your letter of recommendation.

First name

Last name

Business / organization

Title

Email address

Best phone

City

State

ZIP

Letter of recommendation (PDF or Word)

Participation

The Mississippi Leadership Academy consists of two full-day sessions, held one Saturday each month in September and October, at MCPP's offices in Jackson. These sessions are eligible for service/volunteer hours, but you must attend both to receive credit.

I understand the commitment and, if selected, I will attend both full-day sessions. *

Application Form