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IN-9 Congressional Leadership Program
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The Indiana 9th Congressional District is
Bloomington/Monroe County and the southeastern part of the state.
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June 11th – August 6th,
2012
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Introduction to the Congressional Leadership
Program
The Congressional Leadership Program (CLP)
introduces college and graduate students to their region and develops their
leadership skills so they can effectively serve their community. CLP’s
sessions are designed to help a diverse group of high-achieving college and
graduate students learn more about the strengths and challenges of their
community and how they might live a life engaged in addressing those issues.
Applicants should be residents of or
attending college or graduate school in the Ninth Congressional District.
CLP class size is limited, so the application process is competitive.
Priority consideration will be given to those who apply by May 1st,
2012. Applicants must attend at least four out of five sessions to
successfully complete the program.
If you have any questions, please contact our
Jeffersonville Office at 812-288-3999.
Planned Schedule for 2012
(Locations are subject to change)
Monday, June 11th; 9:00 a.m. –
5:00
p.m.
Rural Indiana
Scottsburg
Monday, June 25th; 9:00 a.m. –
5:00
p.m.
Local Government
Bloomington
Monday, July 9th; 9:00 a.m. – 5:00
p.m.
Economic Development
Jeffersonville
Monday, July 23rd; 9:00 a.m. –
5:00
p.m.
State Government
Indianapolis
Monday, August 6th; 5:00 p.m. –
8:00 p.m. Charge
to Lead
Copy and paste the application below into a
Word document to send to the address at the
bottom:~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Congressional Leadership Program
Application
Name:
___________________________________
Date: _______________________
Name to appear on certificate/diploma:
__________________________________________
Contact Information:
Permanent
Address: ________________________________________________________
________________________________________________________
Cell
Phone:
________________________________________________________
School E-Mail
________________________________________________________
Personal E-Mail
________________________________________________________
Parents’ Names
________________________________________________________
Personal Information:
Name of College or University:
________________________________________________
Major:
______________________________ Current G.P.A.
___________________
Grade Level(upcoming semester):
( )Freshman ( )Sophomore (
)Junior ( )Senior ( )Graduate
Please List Two References:
Name: _______________________________
Relation to you: _______________________
Address:
____________________________________________________________________
Phone:
_____________________________________________________________________
Name: _______________________________
Relation to you: _______________________
Address:
____________________________________________________________________
Phone:
_____________________________________________________________________
Additional Requirements:
1. Please attach a resume to the application.
Signature
___________________________________ Date _________________
Please complete the application and return it to:
The Honorable Todd Young
Attn: Congressional Leadership Program
279 Quartermaster Court
Jeffersonville, IN 47130
