You are here
Home
»
Delegates (Students)
» 2023 DELEGATE (STUDENT) INFORMATION
LEADERSHIP, ETHICS,
ASPIRATIONS & DETERMINATION
(LEAD) CONFERENCE
October 12 & 13, 2024
2023 DELEGATE (STUDENT) INFORMATION
DELEGATE (STUDENT) APPLICATION
ROTARY DISTRICT 5340 LEADERSHIP, ETHICS, ASPIRATIONS & DETERMINATION CONFERENCE
Please fill out the form completely and click the "Submit" button. You will receive a confirmation screen with instructions for completing the application process.
DELEGATE (STUDENT) INFORMATION
First Name
*
Last Name
*
My friends call me
*
Sex
*
Male
Female
Home Address
*
City
*
Zip
*
Home Phone
*
Please enter numbers only. Example: 8581234567
Parents Cell
*
Please enter numbers only. Example: 8581234567
Parents Work Phone
*
Please enter numbers only. Example: 8581234567
Students Cell
*
Please enter numbers only. Example: 8581234567
Birth Date
*
Please enter as MM/DD/YEAR
E-mail Address
*
Parent's E-mail Address
*
Adult Shirt Size (Men's)
*
S
M
L
XL
XXL
I am in the 8th Grade
*
Yes
No
Students must be in the 8th Grade.
School
*
Leave this field blank
CAPTCHA
Testing to prevent spam from bots.
Search form
Search
Countdown
168 days until 2024 LEAD Conference.
Navigation
LEAD Home
LEAD Brochure
What is Rotary
LEAD Brochure
Delegates (Students)
What to Bring
Tentative Schedule of Events
Camp Layout
LEAD Brochure
Emergency Information
Map to LEAD
LEAD Bus Stops
School
Letter to Administrator
Student Selection Criteria
LEAD Brochure
LEAD School Timeline
Tentative Schedule of Events
Rotary Club
LEAD Club Timeline
LEAD Brochure
Student Selection Criteria
Tentative Schedule of Events
Advisors
LEAD Club Timeline
LEAD Brochure
Tentative Schedule of Events
What to Bring to LEAD
Map to LEAD
LEAD Bus Stops
Committee
LEAD Video
YouTube Link