Leadership Education for Asian Pacifics, Inc.

LEAP
327 E. 2nd Street,
Suite # 226
Los Angeles, CA 90012
Phone: (213) 485-1422
FAX: (213) 485-0050
Email: leap@leap.org

Community Leadership Conference
- Los Angeles -

Please complete this registration form. You will enter your payment information on the next page if paying by credit card.

* indicates a required field

First Name	* M.I.
Last Name	*
Address 1	*
Address 2
City	*
State	*
Zip	*
Phone	* 888-888-8888
Email	*
Organization/Company/School
Sector	If other, please list
Ethnic Heritage
Generation
* How did you hear about this event?	LEAP Mailing/Brochure Conference Committee LEAP E-Newsletter Colleague Website Friend/Family Other If other, please list
Dietary Restrictions:
Please choose one session each for the morning and afternoon to allow us to anticipate numbers:
Morning Session*
Track 1 - Basics of Conflict Resolution Track 2 - Being a 21st Century Leader Track 3 - Legislation Navigation: Advocating Around Issues of Today
Afternoon Session*
Track 1 - IMPROVe Your Business Skills Track 2 - Making Media / Shaping Democracy: Empowering Youth Citizenship Track 3 - Making a Great First Impression
Please select your method of payment:*
Credit Card [via secure online payment after submitting this form]	Check [mailing information on the next page]