Construction Leadership Institute
Southern Illinois University Edwardsville
School of Business and
Department of Construction, School of Engineering
Construction Leadership Institute
January 12, 2018 – March 9, 2018
Please type or print clearly in black ink.
Applicant Information
Name:
Signature:
Company Name:
Current Position or Title:
Mailing Address: (Please include a physical address and P.O. Box)
Telephone: Fax:
Email Address:
Beginning with your current employer, provide a brief summary of construction experience over the past six to eight years. Include employers, dates of employment, and a description of responsibilities with emphasis on your current duties.
List undergraduate and graduate degrees earned, continuing education programs attended, construction-related courses and examinations passed, and certificates received. (Degree/Certif./Course Program) (Major/Concentration) (Awarding Body) (Date)
Company Information
General Contractor ( Specialty Contractor ( Other (
AGC Member: Yes ( No ( SIBA Member: Yes ( No (
Primary Areas of Construction Activity:
Building: % Municipal-Utilities: %
Highway: % Other: %
Heavy-Industrial: % Collective Bargaining: %
Open Shop: %
Approximate Annual Volume of Work Put in Place by the Firm in 2016: $
Sponsor Information
Name:
Company Name (if different):
Title:
Address: (Please include a physical address and P.O. Box)
Telephone: Email Address:
Attach a letter of endorsement from a principal or the chief executive officer of your firm. This letter should relate the writer’s personal knowledge of your qualifications and suitability for admission to the program. A sample Letter of Endorsement can be downloaded from the Construction Leadership Institute website at: siue.edu/cli, or contact Kristine Jarden at 618-650-2668 or kjarden@siue.edu. (If applicant is the chief executive of the firm, omit this requirement.)
Application may be submitted electronically to kjarden@siue.edu and payment made using the secure online credit card transaction processing available on the CLI website at: , or by check made payable to Construction Leadership Institute; SIUE.
Tuition Fee Schedule: $2950 if payment received on or before November 1, 2017
$3150 if payment received after November 1, 2017
Application Deadline: December 1, 2017
MAIL TO: Construction Leadership Institute
Attention: Kristine Jarden
SIUE School of Business
Campus Box 1051
Edwardsville, Illinois 62026
Phone: 618-650-2668 Fax: 618-650-5353
Email: kjarden@siue.edu
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