Leadership Cape Application


Applicant Information


First name 


Last name 


Business name 




Please list how you would like your name to appear on printed materials 


Time spent in current position 


Business address


Business phone 




Cell number 


Cell carrier (to receive pertinent text alerts) 








Advanced or professional training 


Please submit a head shot to be used in the class directory




Please list all business/professional organizations you are involved with: 


Please list all community/civic organizations you are involved with: 


Have you participated in a similar leadership program in another community? 


Please tell us...


In your opinion, what are the three (3) most critical problems/issues facing Cape Girardeau today? 


Please provide a brief statement of the reason(s) you wish to participate in Leadership Cape: 


What do you expect to gain from participating in Leadership Cape? 




Please provide two (2) professional references other than your current employer.
















If accepted into the Leadership Cape Girardeau program, you or your firm will be billed for the tuition fee of $595 for Cape Chamber members or $645 for non-Cape Chamber members. Tuition covers supplies, meals, transportation, etc. during the sessions. Tuition must be paid in full by March 2, 2020 and is non-refundable.


My tuition will be paid: 


Applicant agreement


By submitting this form,


• I understand attendance at the class retreat (March 13, 2020) is mandatory and if I miss the retreat, I will no longer be a member of the 2020 Class.


• If selected as a participant in Leadership Cape, I am willing to attend all functions sponsored by the program, and I understand attendance is mandatory.


• I understand I am to notify Kim Voelker when I am unable to attend a session.


• I understand if I miss more than one session, I will need to make up the session(s) the following year in order to graduate.


• I understand I will be required to complete a team project which will require an additional time commitment above and beyond regularly scheduled sessions. Participation is mandatory.


• I understand, as a leader, I represent my organization and will conduct myself at all times in a professional manner.


• I understand if I fail to meet any obligations of the program, I may be asked to withdraw or may not graduate with my class.


I have my employer's approval to participate in Leadership Cape. 


Supervisor's name 


Supervisor's email 


Applicant's e-signature 


This completed application must be received by 5:00 p.m. on January 31, 2020 to be considered.


Expect a notification of acceptance by February 14, 2020.


Questions? Call (573) 335-3312, email Kim Voelker.