KARL

I. PERSONAL INFORMATION

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II. EDUCATION AND TRAINING
 
List highest level of education.

Name/Location of School	Attendance Year(s)	Graduation Year	Diploma/Degree	Major

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III. OCCUPATIONAL INFORMATION

Agriculture Production Experience

If currently involved in agricultural production list % of time :

Rank commodities produced in order of predominance:

Please list full time or part-time production (farming, growing, managing) agricultural experience/operation size).

Agri-business and Non-Agricultural Work Experience:
Please list agribusiness experiences or work related to rural communities and any non-agricultural work.

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IV. ORGANIZATIONAL AND COMMUNITY EXPERIENCE
 
List your current memberships and one important past leadership position held.

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V. PERSONAL TRAVEL, INTERESTS
 
List three books, articles, movies or speakers that have given you useful insights during the past year.
Briefly describe your foreign travel, if any. Indicate countries and purpose of travel (business or pleasure).

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VI. CONTRACT SECTION
 
Time Commitment

The Board of Directors of Kansas Agriculture and Rural Leadership, Inc. will provide an excellent educational experience for the benefit of the participants. Selected candidates are expected to attend 100% of the Seminars in order to participate in the study tours and to graduate. Please review the policy below and the listed schedule taking your time commitments into consideration.

Due to the investment of time and financial resources (approximately $12,500 in donations) for each participant, full participation is very important. Participants are asked to commit to 50 days of training. Excluding any unforeseen occurrences or changes in current work or family status, participants indicate whether they will attend all sessions if selected. In the event that a participant would be unable to attend all or part of a seminar, the following policies are drawn to assist in determination of completion of seminars and eligibility for graduation.

Medical Emergency: Personal or Family
If a class member missed a seminar because of a medical emergency, given a file record of medical emergency, the Board would allow the participant to complete the seminars and graduate with their class. The absent class member would be granted the option of participating in the seminar missed with the next class if so desired.

Job Demands
If a class member has an unforeseen conflict arise, was instructed to miss a seminar by a superior, or a farm/ranch emergency prevents them from attending part or all of a seminar, said participant would need to contact the office ahead, or the seminar sight at the opening of the conference, to allow for adequate adjustments and to officially authorize the absence. If the absence was not authorized, the individual would be reminded of the absenteeism policy, following the missed seminar.

Should an individual miss two seminars without authorization, he/she would be placed on probation. A third notation of absenteeism would require a hearing with the KARL Board, where dismissal from the program would be considered. ■ KARL, Inc. pays for nearly all room and board during all seminars. Since most counts are guaranteed, unauthorized absentees of either part or all of a seminar will be billed the actual cost equivalent of meals and lodging missed.

INTERVIEW FOR SELECTION:

In the Event I am selected for Interviews I will be able to attend in my region, or an alternate region if conflicted:

      May 4 NW       May 5 SW       May 6 SC       May 7 SE       May 8 NE

ANNOUNCEMENT AND ORIENTATION:

If selected for the class the official Class Announcement Event and Orientation will take place May 30, 2009 with Members & spouses as KARL, Inc. guests.

Please check one: 
I (we) can attendI (we) can NOT attend Reason if 'No' is selected...:

Excluding any unforeseen changes, indicate whether you will attend all sessions if selected for the class.

Class X (2009-2011) Program Curriculum

  If selected I will be able to attend all seminars: YESNO if 'No' enter conflict date:(mm/dd/yyyy)    Initial:
 

 

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STATEMENT OF UNDERSTANDING

"I understand that if the number of applicants is large, no more than 45 of the applicants may be invited for interviews. I understand that spouses of married candidates (and fiancees of engaged candidates) are encouraged to attend the interview. I also understand that the final selection of applicants is the sole responsibility of the Board of Directors of KARL, Inc."

“I have read the program description provided by the Kansas Agriculture and Rural Leadership, Inc. Board outlining requirements for participation in the KARL Program and agree to support all policies for participation should I be selected. I give my permission for contacting the references supplied. I also agree to release any information contained in my application related to my name, county, city and occupation for publicity purposes, and that address and phone details will not be released to the media."

Part of the program experience includes a lodging rotation with double occupancy to occur at all seminars. Site tours, group meals and other activities occur to supplement formal presentations and to provide for enhanced group interaction and networking. “If selected, I agree to participate in all activities as listed in the schedule including group meals, tours, and the lodging rotation."

Due to the nature of the program tours and travel, a health form will be provided to all accepted candidates for completion. This form will be available only to the director, to be referred to only in the event of illness or emergency, and will be kept confidential.

“I hereby certify that all statements made in this application are true and complete. I agree and understand that any intentional misstatements or omissions of material facts herein may cause disqualification of my application.”


Type name for confirmation     DATE: