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Please complete, print, and email this form to: Beverley Rose, Program Coordinator, Texas A&M AgriLife Advanced Leadership Program
[email protected] /979-458-3279
Participation Confirmation Form – Cohort V
Salutation: Full Name:
Position or Title:
Preferred Name on Name Tag:
Please list any dietary preferences/special needs you would like us to be aware of:
Session Participation: I understand that I have been selected as a participant in the Cohort V class of the AgriLife Advanced Leadership Program, and am fully committed to participating throughout the duration of the two year program. Please confirm your availability for all sessions.
Yes No February 6, 2018 April 16 – 19, 2018
September 24 – 27, 2018
*January 7 & 9-11, 2019 (tbc)
*March 25 -28, 2019 (tbc)
August 12-15, 2019
October 7 – 10, 2019
February 4, 2020
*to be confirmed
Cohort V Meeting & Induction Dinner; College Station Setting the Course; College Station
Leadership Cornerstones; Location TBD
Leadership in Action; College Station [Coincides with proposed 2019 AgriLife Conference]
External Relations; Austin
Leadership Cornerstones; Location TBD
Leadership in Action; Location TBD
Cohort V Graduation & Cohort VI Orientation & Induction Dinner, College Station
Please enter these dates on your calendars; attendance is mandatory at all meetings.
Texas A&M AgriLife Advanced Leadership Program Participation Form - Page 2 of 2
Participant Biography: Please provide a short biography to be used in publication materials for the program. 250–word maximum