Experiential Leadership Intensive

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Experiential Leadership Intensive

We are accepting applications聽for the fall 2024 ELI.聽

Student Name (First & Last) *

Student Email *

Student Phone Number *

Student ID Number *

Student Classification *

Leadership Program Affiliation *

Do you have a car or will you need transportation assistance? *

I have a vehicle and would be willing to help with carpooling.

I will need a ride.

If you have a vehicle, please indicate the number of folks you can bring NOT including yourself. (If you do not have a vehicle, simply put n/a for this question). *

Do you have any allergies we need to be aware of (food, environment, etc.)?

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone Number *

Leave this field blank

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Experiential Leadership Intensive