Signature Program Application

Signature Program Application
Thank you for your interest in Leadership Prince William! To be eligible, you must be at least 25 years of age and live or work in Prince William County, Manassas, or Manassas Park. LPW is a non-political, non-partisan organization. As such, applicants who intend to run for office during their class year are NOT permitted to utilize their class participation for campaign purposes.

Important: Take your time completing the form. If you miss a required field and press submit, you will have to upload your attachments again.

We will not publish your personal information or email address(es) to any third parties. This information is for the sole use of Leadership Prince William.

Application Deadline
Leadership Prince William applications are due before 5:00pm, Monday, June 1, 2026

The Leadership Prince William Class of 2027 will be announced in mid to late July, 2026. Applicants will be notified via mail, email and/or phone. Please be sure your contact information is complete.

PLEASE NOTE: A $50.00 non-refundable application fee must accompany your completed application in order to be considered.

Personal Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Linked in Profile Address
Years working/ residing in Prince William County, Manassas, or Manassas Park*
YesNo
YesNo
Please list the program(s)

Essays, Resume, References, and Employer Support.
Essays (Document 1)

This section allows us to get to know you. Copy and paste these questions into a Word document with your answers and upload them in the section below.

1) What do you hope to gain from your participation in Leadership Prince William? (300 word limit)

2) Community leadership is an important part of our mission. What will you contribute as part of the LPW class? What do you hope to give back to our community as a potential alumni after you complete the Leadership Prince William experience? (300 word limit)

3) In your opinion, what are the two most important opportunities facing the Great Prince William Area? Describe the issue and articulate the challenge. (400 word limit).

Resume/ CV (Document 2)

Review your resume in preparation for uploading below.

Letters of Reference (Document 3)

Secure two letters of reference in preparation for upload below.

Employer Support (Document 4)

In any successful venture it is important to be supported by those closest to you. If you are employed, ensure your supervisor is aware of the time commitment and supports your participation.

Copy and paste the following sample letter and have your supervisor sign it. Then scan and attach it below.

I acknowledge the time commitment required for participation in Leadership Prince William's Signature program, and the program requirements have been clearly communicated to me. I fully support [Participant's name] in participating in the program and agree to accommodate the necessary time and engagement to fulfill all program obligations. [Supervisor's name, title, signature, and date]
Attach a PDF or Word document that includes all of your answers for the Essay Questions.*

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Add your RESUME via PDF or Word document.*

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Upload Supervisor's Statement of Approval*

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Upload Letters of Reference*

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In alignment with Leadership Prince William’s commitment to collaborative leadership and community enrichment, we will conduct an internet and social media review as part of your application process to help ensure a safe, respectful, and community‑minded cohort experience. If there are any key issues or experiences on which you wish to provide context, please provide that information here.

References

Please list the names of two other persons who are knowledgeable about your leadership potential and performance and who may be contacted regarding your qualifications as a Leadership Prince William participant.
Name (Reference #1)*

First NameLast Name
Relationship to you (Reference #1)*
Email (Reference #1)*
example@example.com
Phone Number (Reference #1)*
Please enter a valid phone number.Format: (000) 000-0000.
Title (Reference #1)*
Business/ Organization (Reference #1)*
Name (Reference #2)*

First NameLast Name
Relationship to you (Reference #2)*
Email (Reference #2)*
example@example.com
Phone Number (Reference #2)*
Please enter a valid phone number.Format: (000) 000-0000.
Title (Reference #2)*
Business/ Organization (Reference #2)*

Commitment
In order for Leadership Prince William to be a success, the following guidelines are in place for the benefit and enjoyment of all participants.

If selected as a participant in Leadership Prince William, I agree to attend all of the functions sponsored by the program which include a two-day opening retreat, eight (8) one-day sessions and a closing retreat/commencement celebration. I understand that attendance at the opening and closing retreats is mandatory. Additionally, I understand that full-day attendance for each class session is required and that I will not be allowed to graduate with my class if I miss more than 12 hours of instruction time. I also understand that any absence must be approved in advance and that failure to meet these attendance guidelines will result in a withdrawal from the program and the forfeiture of my tuition.
Applicant Signature*

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Date*

MonthDayYear
Date
If necessary, I have approval and support from my organization, which includes the time required to participate in Leadership Prince William.
Name of Approver*
Phone Number of Approver*
Please enter a valid phone number.Format: (000) 000-0000.
Approver's relationship to you?*

Tuition

When accepted into Leadership Prince William, the participant, financial sponsor and/or employer will be billed for the tuition fee of $3,800. This covers all program costs, including facilitators, Emergenetics training, bus and venue rentals, overnight retreat accommodations, meals, commencement celebration, and an Alumni membership through the end of the calendar year in which a participant graduates the Signature Program. Tuition payments can be made by check, EFT or credit card. Tuition must be paid in full before the start of the Opening Retreat in September. Contact Charles Gilliam at 703-906-9575 if you would like to discuss a payment plan.
Personal addressBusiness employer addressOther
Tuition Assistance
Partial scholarships are available for Leadership Prince William on a limited basis, depending on the number of requests received and funds available. Please indicate below if you will require a scholarship:

Applications for Scholarships are now available and will close on their due date.
Choose the scholarship level that would allow you to overcome the financial burden of the program that would limit your ability to participate. Scholarship funds have been "paid forward" by generous alumni, investing in the future of our community by investing in you. Its purpose is to reduce financial barriers for qualified applicants that wouldn’t otherwise be able to participate in our programs.

500 dollars1000 dollars1900 dollars

Thank you for you interest in Leadership Prince William.
A confirmation email with a copy of your application will be emailed to you.

Selection Process:
A Review Committee, chaired by a member of our Board of Regents, will review all applications and submit their recommendations to a Final Selection Committee. Their recommendations will be compiled to form our final roster for the Class of 2026. All applicants will be notified by email of the final selection once the review process has been completed.

Questions?
Please contact Charles Gilliam, Executive Director, Leadership Prince William: charles@leadershipprincewilliam.org or 703-906-9575.

Application Fee*

Application Fee

PLEASE NOTE: A $50.00 non-refundable application fee must accompany your completed application in order to be considered. Upon selecting this fee, you acknowledge that the amount will be paid.

$50.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Should be Empty:

Signature Program Application

Personal Information

Essays, Resume, References, and Employer Support.

Employment Information

References

Commitment

Tuition

Tuition Assistance

Optional Information

Thank you for you interest in Leadership Prince William.

Payment Methods