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The 2017 Leadership West Volusia Registration Form

Use this form to register for Leadership West Volusia. If you have any questions, please email Stetson University Professional and Corporate Education at pace@stetson.edu or call 321-939-7619.

Deadline: August 3, 2017

Personal Information

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Sponsor Information

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Education

List high school, college, business, and trade schools attended, dates, degrees earned, and major.

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List any academic recognitions/honors or leadership positions held while recieving the formal education listed above.

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Employment

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List previous employer(s): list most recent first

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Organizations and Activities

List in your order of importance up to five community, civic, professional, religious, social, or other organizations of which you are or have been a member.

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General

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Information on Time Commitment

Participants in Leadership West Volusia are expected to attend all scheduled sessions and be present for the entire duration of each one. For emergency reasons, one absence is allowed, with the exception that no retreat, Personal Leadership Development, or graduate exercise may be missed. Absenteeism will result in being dropped from the program (without registration fee refund). Tardiness and/or early departures from meetings will be considered the same as an absence. If you cannot attend Leadership West Volusia under these expectations, it is in your best interest to not apply at this time.

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References

Identify three persons who are familiar with you and your contributions to the West Volusia area.

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Tuition Statement

Payment of $899.00 is due no later than August 3, 2017.

Certification

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Payment Information

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