2026 Leadership Immersion Program Application - Tennessee Medical Association

2026 Leadership Immersion Program Application

2026 Leadership Immersion Program

Dates:

June 26-28 - Session 1 (Monteagle)

July 24-25 - Session 2 (Nashville)

*To complete the program, you must attend both sessions.*

Course Placement

Applications will be reviewed in priority order based on the date of submission, and all course placements will be finalized by fall of 2025. All confirmed participants will receive an email informing them of their enrollment status, along with an invoice of $1,000 for tuition costs. Once the invoice is received, each confirmed participant will be required to pay a nonrefundable minimum deposit of $150 to secure their spot.

Fields marked with an * are required.

First Name *

Last Name *

Email *

Phone *

Cell or Mobile phone preferred.

Designation *

Please select your medical degree designation.

Specialty *

City *

City of Practice

TMA Status *

Are you a member? Yes or No

In order to participate in the Leadership Immersion, you must be a TMA Member. To become a member, follow This Link to our membership page to join.

Component Medical Society *

City *

If your tuition is being sponsored, please list the sponsoring organization below.

How did you hear about this program? *

Please provide a brief description of what you hope to gain from participation in this program. *

Acknowledgement and Signature *

I acknowledge the Leadership Program's course placement process and tuition costs, and understand that I have 30 days from the time I register to pay for my tuition, otherwise my spot may be given to another physician on the waitlist.

Type out your full name.

Please verify that you have checked the “I'm not a robot” checkbox.