2021 Washington State Leadership Initiative (WSLI) Conference Registration

Welcome!

Please complete this form to sign up for the

2021 WSLI Leadership Conference

August 24th 8:30 AM to Noon

Agenda for the virtual event:
Welcome/ Gathering
Opening Speaker
Breakout Workshops
Leadership Panel

Please register using the same e-mail you are going to use to attend the event August 24th.

An email with event details and links will come the week of the event to ensure online security.

First Name

Last Name

I am attending this event as a(n)

Organization Name

Confirm Email

Type of phone

Home Phone

Mobile Phone

Work Phone

County

Recording Disclaimer

I understand this virtual event will be recorded and consent to use of my video and audio.

Gender

My primary language is

We ask this to better serve you in your preferred language, as possible.

Primary language if Other

Language interpretation requested for...

-- 需要語言翻譯 -- 요청 된 언어 번역 -- Языковой перевод запрошен для -- Turjumida luuqada ayaa la codsaday -- Interpretación de idiomas solicitada para -- Phiên dịch ngôn ngữ được yêu cầu cho

Other language interpretation

My ethnicity

Any other accommodation requests or needs please submit by Friday August 13th, 2021.

Contact Information

Caucasian/White	Black or African American
American Indian/Native American/Alaska Native	Asian
Pacific Islander/Native Hawaiian	Two or more races
Unknown	Prefer not to answer

2021 Washington State Leadership Initiative (WSLI) Conference Registration

Welcome! Please complete this form to sign up for the2021 WSLI Leadership Conference

Welcome!

Please complete this form to sign up for the

2021 WSLI Leadership Conference