TCLA Application TitleName*Firm/Organization*Title*County of employment*County of residence*Email Address*Cell Phone*Business PhoneCivic InvolvementHow Did You Hear About the TCLA?*Who recommended you to this Leadership Academy?Headshot*Upload a quality headshot.Accepted file types: jpg, png.Bio*Tell us about you.Date/Location of TCLA you are applying to:*February - March 2021April-June 2021Keep me posted for the next TCLA datesDietary RestrictionsVegetarian (no meat)Vegan (no animal products--no meat, dairy, or eggs)Dairy AllergyWheat/Gluten AllergyPeanut AllergyOtherCAPTCHANameThis field is for validation purposes and should be left unchanged.