12th Annual Leadership Summit Registration

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To register for this year's Leadership Summit, please complete the information below. You will have the opportunity to donate to the Summit's charity of choice, donate to the scholarship fund, and enter the name of your favorite charity. All charity name submissions will be entered into a drawing to receive some of the net proceeds from the event.

Address Line 1
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City
State or Region
Zip

Please enter the name of your favorite charity. All charity name submissions will be entered into a drawing to receive some of the net proceeds from the event.

If you would like to help someone attend that would not otherwise be able to fund their registration, please enter the amount you would like to donate to the scholarship fund.
If you would like to make a donation to the conference's preferred charity during the registration process, please enter the amount you wish to donate.

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