Leadership at the Crossroads : Learning through Service
Conference Cost: $50.00, Students $10.00
Includes Lunch and this book on Servant Leadership


First Name:
Last Name:
Badge Name (if different):
EMail:
Phone Number:
Institution:

Lunch Selection
Traditional Box Lunch
Vegetarian Sandwich

Mailing Address (including City, State and Zip):

Billing Address (including City, State and Zip) If Different:


        Registration Deadline, October 1st


Mail Payment T0:

Registrations Servant Leadership
Office of Continuing Education
Tirey Hall, room 133A
Indiana State University
Terre Haute, IN 47809

By Phone:

Participants may use Visa or
MasterCard when registering by phone
at 812-237-4011 or 800-234-1639,
Monday-Friday, 8:00 a.m.-4:30 p.m.

For registration information call:
812-237-4011 or 800-234-1639