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REAL Montana Application 2022

Date:

mm/dd/yyyy

Full Name:

First Name

Last Name

Home Mailing Address:

Street Address Line 1

Street Address Line 2

City

State

Zipcode

Telephone:

Cell Number

Home Number

Email:

Email Address

Employment Information:

Current Occupation:

Company Name:

Position/Title

Years in Present Position:

Business Address:

Street Address Line 1

Street Address Line 2

City

State

Zipcode

Briefly describe the business you work for including size, type, number of employees, recent changes, corporate status, etc.:

Briefly describe your work responsibilities:

Briefly describe future plans you have for your

business/employment:

What relevant employment have you held in previous years other than with your present employer?

What relevant employment have you held in previous years other than with your present employer?
	Employer	Dates	Position/Responsibilities
1	1	2	3
2	1	2	3
3	1	2	3

Education:

List all schools attended, including high school, college, and/or short courses.

**Education:**
List all schools attended, including high school, college, and/or short courses.
	Name of School	Attendance Dates	Major Degree	Minor Degree
1	1	2	3	4
2	1	2	3	4
3	1	2	3	4
4	1	2	3	4

Other education:

Leadership Experience:

Indicate recent and current membership and leadership positions held in organizations, including agriculture and natural resource industry, civic, church, governmental, military, and professional organizations.

**Leadership Experience:**
Indicate recent and current membership and leadership positions held in organizations, including agriculture and natural resource industry, civic, church, governmental, military, and professional organizations.
	Organization	Dates of Membership	Leadership Roles/Responsibilities
1	1	2	3
2	1	2	3
3	1	2	3
4	1	2	3
5	1	2	3
6	1	2	3

Of the organizations listed above, cite one specific example wherein you personally initiated, developed, and played a major leadership role in the program or the completion of a project:

List relevant awards and honors you have received:

List relevant awards and honors you have received:
	Organization or Granter	Award/Honor
1	1	2
2	1	2
3	1	2

Short Essays (250 words or less each):

Discuss the most important issue(s) facing the agriculture and/or natural resource industries in Montana today. Discuss one specific idea you have in addressing this issue.

If selected for REAL Montana, how will your affiliated industry or organization benefit from the knowledge and experience you gain?

If selected for REAL Montana, how will your local community benefit from the knowledge and experience you gain?

Describe your potential as a leader – strengths and deficiencies. If selected for REAL Montana, what talents and experience can you share with fellow class members?

What leadership traits do you hope to attain through this program?

What leadership roles will you work to attain in the next 5-10 years?

REAL Montana sets a high standard for attendance and participation by all class members. Please describe your level of commitment to the program – how will you prioritize other responsibilities (work, family, volunteer activities, etc.) in order to fully participate in REAL?

Personal Interests:

Indicate your past foreign travel, if any: (List country, reason for travel and dates of travel)

How did you learn about REAL MT? Who encouraged you to apply?

REAL Montana Agreement:

I have reviewed the Participant Commitment Form and 2022-2024 Program Dates and will adhere to the attendance and participation guidelines.

Sign Here

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