CLUB REGISTRATION FORM ROTARY CLUB REGISTRATION FORM & INVOICE LEAD Conference Dates October 12 & 13, 2024 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 the entire form (fields with * are mandatory) then click the "Submit" button at the bottom. Click on "Printer-friendly version" and print the Rotary Club Registration Form & Invoice. Mail payment to the LEAD Treasurer (mailing information at bottom of Invoice). CLUB INFORMATIONRotary Club of(Required) Rotary Club LEAD Chair(Required) Address(Required) Street Address City State / Province / Region ZIP / Postal Code Mobile Phone(Required)Work PhoneEmail(Required) 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 INFORMATION(NOTE: STUDENTS MUST BE SPONSORED IN PAIRS OF ONE BOY AND ONE GIRL):Our Club will sponsor(Required)Select246Students from the following middle school(Required) Our Club will sponsorSelect246Students from the following middle school Our Club will sponsorSelect246Students from the following middle school Our Club will sponsorSelect123456Students from a school without Rotary Club support (selected by the LEAD Committee) Number of Rotarian Advisors volunteeringTotal AdvisorsSelect12345 (Total # Rotarians Sponsored X $0.00 = FREE)(Total # Students from all schools X $300 = Student Amount) TOTAL REGISTRATION AMOUNT due is automatically calculated and displayed on the Rotary Club Registration Form & Invoice appearing after this form is submitted. Total Registration Amount Due by August 31 The Rotary Club Registration Form & Invoice will be your Club’s Receipt for Payment. Please Mail Payment for the Total Registration Amount by August 31 to: Paul E. Pierce, Jr., LEAD Treasurer, 701 Palomar Airport Road, Ste. 30030, Carlsbad, CA 92011IMPORTANT PAYMENT INSTRUCTIONS: Please click the Submit button below to submit your registration and view your Rotary Club Registration Form & Invoice showing the Total Registration Amount due. You may print a copy of the Invoice for your Club's records by clicking the "Printer-friendly version" button at the top of the Invoice. Please mail payment for the Total Registration Amount by August 31 to: Paul E. Pierce, Jr., LEAD Treasurer, 701 Palomar Airport Road, Suite 30030, Carlsbad, CA 92011CommentsThis field is for validation purposes and should be left unchanged.