Board Leadership Training

Name

First

Middle

Last

Your Contact Information

Company/Organization

Email

Phone

Address

City

State

ZIP Code

Ethnicity

Black

Hispanic or Latino

White

American Indian or Alaska Native

Asian

Native Hawaiian or Pacific Islander

Do you currently serve on a board?

Yes

No

Which boards do you serve on?

How many years have you served on a board?

Do you hold a leadership position?

Yes

No

Which position(s) do you hold?

Class Registration - $75

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Name(s) of Attendees

Total $ 0 Update

Class registration is $75 per person. After completing this form you will be redirected to our payment page where you will be able to process your transaction in a secured environment. Please be sure to enter the same values that you have entered on this form. Thank you!

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Scholarship

Why is participating in Board Leadership Training important to you?

How will you use the information learned to strengthen the organization that you serve and/or the community in which you live or work?

If you do not receive this scholarship, do you have other means to process payment?

Yes

No

Are you interested in a full ($75) or partial ($35) scholarship?

Full

Partial

Either

Please note that a single organization is eligible for a maximum of $75 of scholarship per session.

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