Continental Breakfast and Registration will begin at 10:00am on October 25th.

E-Mail*

First Name*

Last Name*

Campus/Permanent Address

City

State

Zip

Phone Number

Fall 2008*
Freshmen
Sophomore
Junior
Senior

Clubs/Student Organizations Affiliated with

I attended last semester's Leadership Quest 2008 - Follow the Leader.
If yes please check

I currently hold leadership positions in the following University Student Clubs and/or Organizations.

I have done community service with the following community organizations.

I understand that I must attend the entire workshop from start to finish in order to recieve my certificate of completion. These certificates are only given out at the end of the workshop.

I Understand