Lead 2018 Application

You can fill out the online form below or download an application to fill out and drop off.

* indicates required field

(This will be the primary email address we will use for all program communication)


Employment (if applicable)


Financial Commitment

If accepted into Lead Culpeper 2018, you or your employer will be invoiced for the tuition of $1095. Tuition includes all course materials, overnight stay, one attendee to Annual Banquet, meals and special transportation when needed. Tuition must be paid in full by January 1, 2018. Special payment options may be available upon request.


Participation Guidelines

Attendance and participation are important elements of Lead Culpeper 2018. The retreat sessions are mandatory and only one absence will be permitted during the remainder of the program. Any additional or inexcusable absence will prevent you from graduation. If selected, you will be expected to devote this required time to the program.

I understand the above participation guidelines and agree to be on time and prepared for each session.


Employer Endorsement

for Lead Culpeper 2018 and support his/her excused absences from work in order to fulfill program requirements.

APPLICATION DEADLINE IS NOVEMBER 1, 2017
FULL TUITION PAYMENT DUE BY JANUARY 1, 2018
Contact Martha Sanford if you have questions.
marthas@culpeperchamber.com | 540-825-8628