Leadership Anne Arundel- Build- NLA Registration Form

Neighborhood Leadership Academy Online Schedule and Registration Form

Applications must be received by LAA no later than October 1, 2007

Tentative Schedule for 2007-2008
Classes are held Saturdays with the exception of two events* (Opening Retreat & Bus Tour) which are held on Friday. Classes generally run from 9:00 a.m. to 3:00 p.m. with continental breakfast and lunch provided on each session day:

November
November 3, 2007
November 16, 2007*
November 17, 2007 December
December 1, 2007
December 14, 2007* January
January 12, 2008

February
February 2, 2008
February 16, 2008 March
March 1, 2008
March 15, 2008 April
April 5, 2008
April 19, 2008

May
May 3, 2008
May 17, 2008 June
June 12, 2008 -
Graduation

Please fill out this NLA registration form and submit below.

Name:
I prefer to be called:
I prefer all correspondence sent to:	home business
Home Address:
City:
State:
Zip:
Employer/Organization (if applicable):
Position/Title:
Business Address:
City:
State:
Zip:
Business Phone (w/area code):
Home Phone (w/area code):
Cell Phone (w/area code):
FAX (w/area code):
E-mail Address:
Current Community Involvement If you are already working in community service organizations, what are you doing at the present time?
Participation What possible barriers would you have as part of your commitment to the schedule provided below?
Expectations What do you hope to gain from your participation in the Neighborhood Leadership Academy program?
Vision After completing the Neighborhood Leadership Academy, how would you envision using what you learn?
Referred by:
Today's Date:

You may prefer to download these print forms:
2007-2008 Neighborhood Leadership Academy Application (pdf)
or, Word version

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Neighborhood Leadership Academy Online Schedule and Registration Form

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