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Blandin Community Leadership Program Application

Blandin Foundation Leadership Programs does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, selection of volunteers including program participants and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, participants, volunteers, independent contractors, and vendors.

Tell Us About You

The first name you would like to appear on your name tags

2 character limit


Race/Ethnicity (select all that apply)



Please also include any elected government office(s) you currently hold (e.g., city council, county commissioner, township official, school board, etc.)


By checking the 'I understand' box below, I understand this is a residential program and agree to be present for the entire eight days (retreat and workshops) of training. 

We respect that your personal information is sensitive and we are mindful about how we share it and who we share it with. Your name and contact information will be shared with alumni, partners, selection committee, and your cohort to connect leaders in rural Minnesota to help build healthier communities.

Questions?  Call Becky Adams at 1-877-882-2257 Ex 736 or send her an email.


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