Membership Application

Application for GNL Masters Class XXVII

GNL MISSION: The mission of Greater Naples Leadership is to provide proven leaders with a unique opportunity to learn firsthand about the issues and needs in Collier County and to encourage the use of their skills individually and collectively in bettering the community.

APPLICANTS: Please create a password for your application. If you do not complete your application in one sitting, save your work by hitting "submit." You may log in and return to edit the application before submitting a final version. Your username (your email address) and password will be emailed to the email address you enter. Please answer ALL questions carefully and thoroughly. This application is the basis of your candidacy.

If you have a GNL sponsor, he/she will review this application AFTER you submit your final version and BEFORE GNL review. If you are self-sponsoring, your application will be sent for GNL review when you submit your final version.

Your First Name *

Your Last Name *

Preferred Name or Nickname *

This name will appear in the printed directory.

Password

Please enter a password (up to 10 characters). Your user name and password will be emailed to you.

Gender *

Female

Male

Birth Year (optional)

This will not display in your directory profile.

Spouse/Partner Name (optional)

1. Contact Information

Local Street Address

Local City

Local State

Local Zip Code

Local Phone Number

Cell Phone Number

Email Address

Is Florida your legal residence?

Yes

In which county is your residence?

2. Alternate Contact Information

If your local address is not your primary residence, or if you have an alternate address, please check the box below.

I have an alternate address

Alternate Street Address

Alternate City

Alternate State/Province

Alternate Postal Code

Alternate U.S./Canada Phone Number

Alternate Non-US/Canada Phone Number

Alternate Country

3. Business Address

Do you have a business address?

Yes

Business Name

Business Address

Business City

Business State/Prov.

Business Postal Code

Business Country

Business Phone Number

Business Email Address

13. Education History

Please list your three highest degrees from an accredited college or university.

College or University

Field of Study

Degree

Other Degree

Year Completed

College or University

Field of Study

Degree

Other Degree

Year Completed

College or University

Field of Study

Degree

Other Degree

Year Completed

15. LOCAL Nonprofit and Civic Involvement (Current and Past)

"Involvement" is volunteer work for any local nonprofit or civic organization. Please select from the drop-down list of organizations in Southwest Florida. Then select your role and the beginning and ending year for that involvement. Homeowners' associations, churches, country clubs, civic (elected) and civic (appointed) will be listed by general category. If you do not see your organization on the list, please contact the GNL office, 239.300.7055 or GNLoffice@GNLwebsite.org. Enter up to 12 involvements below. As you enter information, another set of fields will appear. The order of your list doesn't matter but PLEASE put either Current or a year in the last column.

Organization Name

Your Role

Begin Year

End Year

Organization Name2

Your Role2

Begin Year2

End Year2

Organization Name3

Your Role3

Begin Year3

End Year3

Organization Name4

Your Role4

Begin Year4

End Year4

Organization Name5

Your Role5

Begin Year5

End Year5

Organization Name6

Your Role6

Begin Year6

End Year6

Organization Name7

Your Role7

Begin Year7

End Year7

Organization Name8

Your Role8

Begin Year8

End Year8

Organization Name9

Your Role9

Begin Year9

End Year9

Organization Name10

Your Role10

Begin Year10

End Year10

Organization Name11

Your Role11

Begin Year11

End Year11

Organization Name12

Your Role12

Begin Year12

End Year12

16. OUTSIDE SWFL Involvement

Please list name(s) of organization(s), position(s)/role(s) and years involved (current)

Please list name(s) of organization(s), position(s)/role(s) and years involved (past)

18. Sponsor Information

Are you being sponsored by someone in GNL?

Yes

Sponsor Name

Sponsor E-Mail

Application Submission

Is this your final submission? If so, say YES and a copy of your application will be emailed to you. If NO, you will need to log in to edit or finish your application. Your application will not be reviewed by your sponsor or GNL until you indicate that it is your final submission. Note: Do not leave the screen until you see "Your form is successfully saved."

Yes

Application for GNL Masters Class XXVII

1. Contact Information

2. Alternate Contact Information

3. Business Address

4. About You

13. Education History

14. Career History

15. LOCAL Nonprofit and Civic Involvement (Current and Past)

16. OUTSIDE SWFL Involvement

17. Please acknowledge your understanding of the following by selecting "Yes" or "No." I understand that:

18. Sponsor Information

Application Submission