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Contact Information + Demographics

First Name *

Last Name *

Name Pronunciation

Pronouns *

They/them

She/her

He/him

Email *

We recommend using a personal email address rather than a work email.

Phone 1 *

Phone 2

Address Line 1 *

Address Line 2

City *

State/Province *

Zip/Postal Code *

Country

LinkedIn Page

Birth Year *

Gender Identity *

agender

genderqueer or genderfluid

Man

Nonbinary

questioning or unsure

two-spirit

Woman

Prefer to self-describe (please use gender identity comment section below)

Select all that apply.

Gender Identity Comments

Do you identify as Black, Indigenous, or Person of Color? *

Racial and Ethnic Identities (select all that apply) *

Alaska Native

Asian

Black or African American

East Asian

Latino/a/x/e or Hispanic

Filipino

Mestizo

Middle Eastern or North African (MENA)

Native American, American Indian, or Indigenous

Native Hawaiian or Other Pacific Islander

South Asian

Southeast Asian

White

Other

Other Identities:

Tribal or First Nations Membership

LGBTIQ2S+

New Class Member Information

Name for Directory and Materials *

Please enter your first and last name exactly as you'd like it to appear on your nametag, the LT website, class directory, class roster, and graduation certificate.

Racial Caucus Group *

Select the racial caucus group you would like to join. You may change your selection at any time during the program year.

T-Shirt Size *

Emergency Contact Name *

Emergency Contact Phone Number *

Dietary Restrictions *

I do not have any dietary restrictions.

Diabetic

Kosher

Halal

Vegetarian

Vegan

No Milk/Dairy Products

No Eggs

No Wheat/No Gluten

No Peanuts

No Nuts

No Red Meat (Poultry and Fish Only)

No Pork

Pescatarian

No Shellfish

No Fish

Other Dietary Restrictions

Medical Needs and Accommodations *

I do not need any accommodations.

ADA Accessibility

EPI Pen (Carry with me)

ASL

Wheelchair Accessible

Blind/Visually Impaired

Deaf/Hard of Hearing

Other Medical Needs/Extra Info

Do you consider yourself more introverted or extroverted? *

Do you grant Leadership Tomorrow permission to use photographs or videos in which you appear? *

If you choose not to grant permission, please help us honor your preference by making photographers aware and stepping out of group photos when possible.

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Employment Information + Skills

Are you retired?

Company Name *

If you are not currently employed, please enter "Community Leader."

Job Title

Work Sector *

Skills

Accounting

Architecture

Advocacy

Art & Design

Business

Civil Engineering

Climate Mitigation / Adaptation

Coach - Life/Executive/Leadership

Community Organizing & Outreach

Conflict Resolution

Construction

Contract Writing

Counseling/Therapy

Cultural Competency

Curriculum Design

Data Analysis

Education & Training, Adult

Elected Office (running for or serving)

Education, Early Childhood

Education, Higher Ed

Education, K-12

Entrepreneurship

Environment/Environmental Justice

Equity and Inclusion

Event Planning

Facilitation (retreats, meetings, training)

Finance

Fundraising

Government Relations

Homelessness Services / Issues

Housing Development

Human Resource Management

Immigration

Law Enforcement

Legal

Marketing/Communications/PR

Medicine

Nonprofit Development

Organizational Development

Parks & Recreation

Policy Analysis

Political Campaigns & Elections

Program Design & Evaluation

Property Management

Public Health

Real Estate Development

Renewable Energy

Research

Risk Management

Sales

Social Work

Software Engineering/Development/Programming

Strategic Planning

Sustainability

Team Building

Transportation

Unions / Union Organizing

Urban Planning

UI/UX

Video/Audio Production

Volunteer Management

Writing and Editing

Website Development

Youth Advocate

Volunteer Interests

Interests

Accessibility

Animal Welfare

Arts & Culture

Boards & Commissions (serving on)

Bridging Political/Ideological Divides

Child Welfare

Civic & Neighborhood Action

Civil Rights

Climate Change

Community Projects

Disaster Preparedness

Domestic Violence

Early Childhood & Parenting

Economic Development

Economic Equity

Education K-12

Education, Higher Education

Education, Adult

Environment & Sustainability

Faith Based Communities

Health & Wellness

Homelessness & Housing

Hunger & Basic Needs

Immigrant & Refugee Communities

Immigration

International Relations

Jobs & Income

LGBTQ+

Parks and Public Space

Philanthropy

Political Campaigns & Elections

Public Policy & Government

Racial Equity

Recreation & Sports

Senior Services

Social Justice & Human Rights

Substance Abuse

Sustainable Development

Technology & Science

Transportation

Veterans

Women and Gender Equity

Youth and Family Services

Youth Development

On which boards or commissions do you currently serve?

On which boards and commissions have you previously served?

Where do you volunteer (not including boards or commissions)?

Would you like to be mentored by an LT alum?

Would you like to mentor an LT alum?

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