Paul Clarke and Indiana United Ways Leadership Series Registration Form

Name *
Name
Please enter your LEGAL first name
If you'd like us to call you something besides your given name, let us know!
Phone *
Phone
Please include your area code
Please enter the LAST 4 DIGITS of the credit card you will be using as payment
Address *
Address
Please tell us about yourself *
select that which best reflects your primary role as a participant
Please tell us about your organization *
What primary role does your organization serve?
Please tell us about the size of your organization *
We count employees as people who are ensuring the day-to-day operations of your organization, irrespective of whether they are full or part-time, paid or volunteers; Board members would not be considered staff for our purposes, unless directly involved in the daily operations of your organization (delivering programming on a regular basis, for example)
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