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Leadership Interest Form
Name Email
Year Major 1st Year Undergrad 2nd Year Undergrad 3rd Year Undergrad 4th Year Undergrad 5th Year Undergrad Graduate Other
Campus Mail Address
City State Zip Permanent Mail Address City State Country Zip
In what areas would you like to develop your leadership skills and why?
What days and times work best for you? (Check all that apply)
Day
Time of Day