Fall Leadership Conference Registration
Send checks to Kathy Rossetti no later than October 28th at: 21405 W Brittle Bush Ln Buckeye, AZ 85396
Please enter your School Name/Community Club Name (if not applicable, put N.A.)
*
Sponsoring Rotary Club (if not applicable, put N.A.)
*
Group Contact E-mail (for registration purposes! Please enter an e-mail with someone that represents your whole group and will respond in case there are issues with your registration.)
*
Confirmation Email
Group Contact Phone Number (for registration purposes! Please enter an e-mail with someone that represents your whole group and will respond in case there are issues with your registration.
*
-
Area Code
Phone Number
Back
Next
Attendee Information
It is very important that you click "save" after every entry. If you do not save it, then we will not get your information.
Faculty/Rotarian Advisor(s)/Individual Registrations
Interactors/Additional High School Students:
Back
Next
Please confirm all of your information in the prior pages before submitting!
Submit
Should be Empty: