Women's Higher Education Leadership Summit
June 8-11, 2014
* required information
Registration 
Registration Information
Title:
First Name:*
Last Name:*
Email:*
Address Line 1:
Address Line 2:
City:
State:
Province:
ZIP/Postal Code:
Country:
Organization:*
Job Title:*
Phone:
Business Phone:
Cell Phone:
Gender: Female   Male  
Age: years old
I would like to be on future mailing lists for events like this: Yes
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Fees
Please Select a Program

Additional Information
Group Members:
What is your biggest leadership challenge?:*
What leadership skill would you like to improve upon or develop the most?:*
Are you in need of any special assistance?: Yes
No
If yes, please list:
How did you hear about the WHELS event?:*
If Other: