Public Affairs Documents PLI of Polk April 2018 application | Page 3

Have you filed as a candidate for political office or do you plan to file?
____ Yes _____ No.
If yes, please state the office:
If you have not filed, when do you plan to do so?
1. Please describe (in 300 words or less) what you view as the most important public-policy issue (or
issues) facing Lakeland or Polk County today and how any specific skills, talents or experiences from
your business/professional background could be used to address this (these) important public-policy
challenge(s)?
2. Please list any leadership roles you currently hold or have held within the past five years in profes-
sional, business, civic or social organizations.
In addition, please describe any accomplishment(s) that resulted from a leadership role in a profes-
sional, business, civic or social organization (not including employment) within the past five years.
If this question does not apply to you, do you plan on becoming more engaged in the community?
How? In what area(s)? Do you have a strategy or timetable for involvement?
3. What specifically do you hope to learn and do with what you learn in the Public Leadership Institute
of Polk County? Please answer in 150 words or less.
4. How did you hear about the program?
5. Have you ever held an elected or appointed government office or served on a government board,
task force or commission? __Yes __No If yes, please list the office(s) or board(s) and years served:
6. Prior to this upcoming election, have you been a candidate for political office?
_____Yes _____ No If yes, what was the office and when did you run?