Signature Class 50

Congratulations and welcome to Leadership SBM’s Signature Class 50! We’re excited to begin this journey with you. Over the next year, you will discover both the challenges and strengths of St. Joseph County, connect with your passion for service and leadership, and learn alongside other servant leaders to build a better community.

Signature Class 50 Acceptance

I acknowledge that:(Required)

Attendance at the retreat, Sept 14-15 is mandatory.

Missing more than two program days will result in removal from Class 50.

Once I have accepted this invitation, payment in full is due by August 31 unless other arrangements have been made.

Refunds will not be issued.

I accept the invitation to participate in Signature Class 50.

Please, sign here to acknowlege that you have read and accepted all the items checked above.(Required)

Sponsoring Organization(Required)

Sponsor Email (this address will receive a copy of the tuition invoice)(Required)

Check here to pay via credit card.

Please note, a processing fee of not more than 3% will be added to all credit card payments.

Yes! I want to pay via credit card.

Name (As you would like on your nametag)(Required)

First Last

Preferred Pronouns

Preferred Email(Required)

Enter Email Confirm Email

Cell Phone(Required)

Address(Required)

Street Address City State ZIP Code

Food Allergies or Other Meal Considerations (Vegan, Gluten Free)

Other Situation or Accomodations

Please, note any other necessary accommodations or information that will help us prepare for the Signature Program.

Photo Release

I grant to Leadership South Bend/Mishawaka, its representative and employees, the right to take photographs of myself/my likeness. I authorize them to use and publish the same in print. I agree that they may use such images of me/my likeness with or without my name and for any lawful purpose, including for example such purposes as publicity, yearbook, illustration, advertising, and web content. I have read and understand the above:

Printed Name of Participant

Date

Signature Class 50

Signature Class 50 Acceptance

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