First Name *

Last Name *

Title/Role *

Organization that you are representing *

Phone *

Address Line 1 *

City *

State *

Enter required value

Zip Code *

Email *

How did you hear about Leadership Beaverton? *

Enter required value Employer LB Alum Chamber Online Other

Why are you applying to Leadership Beaverton – what are you most excited about? *

Provide your background in community service. *

What do you think you will gain as a graduate and how will that impact the broader community? *

Leadership Beaverton Program Tuition *

Participants will be invoiced upon selection.

An early-bird discount of $50 will apply to all applications received by June 30.

Tuition is expected to be paid in full within 30 days of acceptance unless arrangements have been made.

Member of the Beaverton Area Chamber of Commerce ($795)

Non-Member ($895)

Are you interested in a partial scholarship?

The Chamber staff will be in contact with you.

Yes No

Commitment Pledge

I understand that if accepted into Leadership Beaverton, I have made the following commitments. 

By checking the boxes you agree and commit to:

I will participate in all program day activities as outlined.

I acknowledge that some outside time will be required to successfully complete our class project.

I acknowledge that this is a two-year commitment and will serve as co-chair planner for the program year following graduation.