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��㴫ý Leadership Academy Application

��㴫ý Leadership Academy Application

Contact: Cooper Hoffmeyer
[email protected]
Manager, Leadership Training & Development
(202) 266-8009

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Applicant Information

First Name: Last Name: Email: Phone: Member Number (PIN): Association: Do you have any dietary restrictions?

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Yes No

Please list your dietary restrictions:

Demographic Information

Please indicate your region: How many years have you been a member? What is your local membership size? What is your state association membership size?

Leadership and Volunteer Information

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I certify that I have a minimum of two years of active national engagement completed through committees, councils, events or similar activities.

Have you held any of the following Leadership Titles within your Local HBA? (Select all that apply)

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Committee Member Committee Chair Board of Directors Secretary Treasurer Vice President President Past President Other

Have you held any of the following Leadership Titles within your State HBA? (Select all that apply)

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Committee Member Committee Chair Board of Directors Secretary Treasurer Vice President President Past President Other

Have you held any of the following Leadership Titles at ��㴫ý? (Select all that apply)

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Committee / Council Member Committee / Council Chair Leadership Council Delegate Board of Directors Senior Officer Other

How many years have you been involved with volunteering in the Federation? Please list any committees or councils you have served on at your Local HBA. Please list any committees or councils you have served on at your State HBA. Please list any committees or councils you have served on at ��㴫ý. Have you ever attended the IBS?

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Yes No

Have you ever attended the ��㴫ý Spring Leadership Meeting and/or the ��㴫ý Legislative Conference?

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Yes No

Have you ever attended the ��㴫ý Fall Leadership Meeting?

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Yes No

HBA Information

HBA Executive Officer Name: HBA Mailing Address: HBA Executive Officer Email:

Letters of Support

You must submit two signed letters of support from your Local or State HBA Executive Officer, your Local or State HBA President, a ��㴫ý National Area Chairman (NAC), or from a ��㴫ý State Representative (State REP). Your application will not be considered if two letters of support are not received by the application deadline.

Choose File 1 to Upload: Choose File 2 to Upload:

If you do not currently have your signed letters of support, you may email it to [email protected].

Essay Questions

Please respond to the following questions, limiting each of your responses to 250 words.

Every leader has a unique leadership journey made up of their personal experiences. Tell us about your leadership journey at the local, state, and national level. What are your future goals as an industry leader, and what do you hope to get out of participating in the Leadership Academy?

Questions or Comments

Please share any questions or comments you have for ��㴫ý staff.

Upon successful submission of this application, you will receive a confirmation email. If you do not, please contact Cooper Hoffmeyer.

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By submitting this form, I acknowledge that I will receive notification by February 2, 2026, that states if my application has been accepted for the 2026 Leadership Academy Class.

If the Submit button is grayed out, please make sure that all required fields are filled in.

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Applicant Information

Demographic Information

Leadership and Volunteer Information

Company Information

HBA Information

Letters of Support

Essay Questions

Questions or Comments