Online Application Form



Applications will be accepted in the Cooperative Extension Office at the County Administration Building beginning July 1, 2016. The deadline for submissions is August 31, 2016. The first 25 applicants who return their application form plus the $50 registration fee to the Extension Office will be registered for the program. Additional applicants will be placed on a waiting list.

To apply, please fill out the following application form. By completing the form and hitting Submit you agree to attend as many of the meetings as possible, with the understanding that missing more than three (3) sessions will jeopardize your eligibility to complete the course. Each class covers a unique aspect of Fluvanna County with relevant speakers only available for their class, so we encourage applicants to consider whether their schedules will allow for attendance at most classes before applying.

2016-17 Application

PDF Application

Make check payable to “Fluvanna Leadership Program
and submit by mail or in person to:

c/o VCE-Fluvanna Unit
P.O. Box 518
Fork Union, Virginia 23055

Phone: (434) 591-1950