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GFWC LEADS PARTICIPANT APPLICATION FORM

Name:________________________________________________________________
Address:______________________________________________________________
Phone:_________________________Email:_________________________________
Club:_____________________________________________District:_____________

Above information should be concealed during judging process

List all local club offices and/or chairmanships held*:__________________________


____________________________________________________________________________
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List all district offices and/or chairmanships held*:_____________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
List all GFWC club/district programs/projects in which involved*:_______________
____________________________________________________________________________
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____________________________________________________________________________
List positions at district/state/national level in which you are interested*:_______
____________________________________________________________________________
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Are you willing to:


 Defray costs to attend GFWC LEADS not covered by GFWC or state? Yes___No___
 Return to the state and share what you have learned at LEADS? Yes___No___

DEADLINE FOR SUBMISSION: FEBRUARY 1ST

*If more space is needed, please attach a separate sheet to this form.
Return this form, along with 2 letters of support from active GFWC club members to:

Kia LaBracke, Leadership Chairman


N62 W37562 Parkview Drive
Oconomowoc, WI 53066-1716
262-569-0074
labracke@sbcglobal.net

LEADS application adapted from a form developed by Lee Humphrey, GFWC Kansas

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