LEAD UNITED Registration Form

Name

Email

Prefered Phone Number

Phone type

- Select -Home Work Cell

Address

Address type

- Select -Home Work

Birthdate

Employer

Title

Length of Employment

My supervisor is aware of the time commitment needed for Lead United? (Six 2-hour sessions will be held in-person plus reading time on your own ahead of each session)

- Select -YesNo

Supervisor's Name

Supervisor's Title

Supervisor's Mailing Address

Can you meet the attendance requirements for participating (5 of 6 sessions) in Lead United granted no emergencies occur?

- Select -Yes No

Have you served on any nonprofit board or committee before? If yes, please explain.

Do you currently volunteer with any nonprofit? If yes, please explain.

Why are you interested in participating in Lead United?

Preferred form of payment - Credit Card, Check, Cash (Once your application has been accepted a TUW staff person will assist you to complete your payment.)

- Select -Credit Card Check Cash

Checkbox to opt into receiving text messages about Lead United - session reminders, links to login, etc.

- None -Yes

T-shirt size

- Select -Small Medium Large X-Large XX-Large

Submit