LEADERSHIP, ETHICS,
ASPIRATIONS & DETERMINATION
(LEAD) CONFERENCE

October 14 & 15, 2017

 

Rotary Club Registration Form

ROTARY CLUB REGISTRATION FORM

AND INVOICE FOR PAYMENT

The Annual LEAD Conference is designed to help 8th grade students improve their leadership skills, develop a positive attitude, and incorporate ethical behavior in their everyday lives.

Your Rotary Club’s sponsorship of students from one or more middle schools to the LEAD Conference will increase Rotary’s positive impact on the young people in District 5340.

Please complete entire form then click the "Submit" button at the bottom.

Click on "Printer-friendly version" and print the Rotary Club Registration Form and Invoice for Payment. Mail payment to the LEAD Treasurer (info at bottom).

 CLUB INFORMATION
Please enter numbers only. Example: 8581234567
Please enter numbers only. Example: 8581234567
Please enter numbers only. Example: 8581234567
 

PLEASE NOTE:

  • All Rotary Clubs are urged to sponsor 8th grade students to LEAD so that all areas of the District are represented.
  • —Students must be sponsored in pairs of one boy and one girl and a minimum of two students (i.e., one boy and one girl) must be selected from each school (see the website for detailed selection information).
  • —Rotary Clubs may sponsor students from more than one school and may sponsor 2, 4, or 6 students from each school.
  • —Rotarian Advisors help supervise the program activities at the LEAD Conference. There is no cost for Advisors.
  • —If your Rotary Club sponsors an Interact Club, it is suggested that your Club sponsor students from middle schools that send students to the high school where your Interact Club is located. You can establish a relationship with the LEAD students and encourage them to participate in Interact and other Rotary programs upon graduation to high school.
 CLUB SPONSORSHIPS

(NOTE: STUDENTS MUST BE SPONSORED IN PAIRS OF ONE BOY AND ONE GIRL):

 
 

from a school without Rotary Club support (selected by the LEAD Committee)

Total Advisors -

 (Total # Rotarians Sponsored X $0.00 = FREE)


TOTAL REGISTRATION AMOUNT due is automatically calculated and displayed on the receipt page appearing after this form is submitted.

(Total # Students from all schools X $250 = Student Amount)

Total Registration Amount Due by August 15

The receipt page will be your Club’s Receipt for Payment.
Please Mail Payment for the Total Registration Amount by August 15 to:

Paul E. Pierce, Jr., LEAD Treasurer, P.O. Box 235080, Encinitas, CA 92023-5080 

IMPORTANT PAYMENT INSTRUCTIONS: Please click the Submit button below to submit your registration and view your receipt showing the Total Registration Amount due.  You may print a copy of this receipt for your records by clicking the big yellow "Printer-friendly version" button at the top of the receipt page.  Please mail payment for the Total Registration Amount by August 15 to:  Paul E. Pierce, Jr., LEAD Treasurer P.O. Box 235080, Encinitas, CA 92023-5080
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