Fields marked with an * are required

Who is recommending you for Leadership Newark? (Self-referred applications are accepted as well)

Personal Information

Employment Record

Briefly describe your present job responsibilities and the nature of your work.

Employment History

List most recent first

Civic Involvement

List in order of importance to you, your business, civic, religious or political memberships/professional affiliations.

Personal Goals and Participation in Leadership Newark, Inc.

Vision for the Newark Community


Please begin with high school and list colleges, graduate education and/or specialized programs.


Emergency Contact


Submit two (2) written letters of recommendations by the application deadline.

Personal Background

Completing this section is voluntary. The information will be helpful in ensuring that the class represents the diversity of Newark. Leadership Newark strives to ensure each class reflects ethnic, geographic and professional diversity.

How do you choose to describe your race and/or your ethnic background?

Applicants Commitment

One is first a servant then a leader - Leadership Newark’s program takes place one full business day each month from September 2019 through September 2021. [A retreat is scheduled in late September or early October for 2 consecutive days usually a Thursday and Friday. Participation in the entire opening retreat is mandatory.] In year two, meetings are scheduled once monthly at the convenience of the group from November 2020 through June 2021. Leadership Newark Fellows are expected to attend all seminars, training sessions, and activities. Candidates should have the support and commitment of their employers to ensure an understanding of the time commitment required for Leadership Newark participation.

Leadership Newark is generously supported by grants from foundations, corporations and donors. Upon acceptance to the program, Fellows are required to pay a modest tuition to cover materials. This will be due at the time of acceptance. Notification of acceptance will be in late August.

Tuition for the Class of 2020 program is $2,500 for the 2-year fellowship program. Upon acceptance payment arrangements/options will be shared with each perspective candidate.

A.  Submit two (2) letters of recommendations with this application or you may have them sent under separate cover directly to Leadership Newark, Inc., 494 Broad Street, Suite LL10, Newark, NJ 07102 or via email to

B.  I understand the purpose of Leadership Newark.  I will commit myself and my time to complete the program.  After the conclusion of the education and training program, as a Leadership Newark graduate, I will continue to support the activities of Leadership Newark.

C.  I understand the applicable tuition payment of $2500 is due in full at time of acceptance.

D.  I understand all pictures taken at program events are the sole property of Leadership Newark, Inc. My signature below authorizes their use in promotional materials and articles about the organization.

E.  I have the cooperation and support of my employer.

This electronic submission implies my consent to the terms and condition listed in lieu of my signature.