Green Room Registration - Invoice - Leadership Louisville CenterLeadership Louisville Center

Green Room Registration – Invoice

If you encounter any difficulties completing this registration form, please contact Peggy Clements at (502) 561-5228 or email pclements@leadershiplouisville.org.

Upon completion of this form, we will enroll you in the course you choose, and email you an invoice. Payment is due upon receipt.

Choose your course
Please register me for:*
Discount code (if applicable)
Name and Title
Courtesy Title
First Name*
Middle Initial
Last Name*
Suffix
Preferred First Name
Current Employment
Professional Title*
Employer*
Occupation Category*
Please select the occupational category below that best describes your company/organization.
Business Address*
Business City*
Business State*
Business Zip*
Business Phone*
(###)###-####
Cell Phone*
(###)###-####
Preferred Email*
Preferred Email - hidden
Hidden as of Aug 3, 2016
Other information
Diversity is an important part of our mission. Please answer these questions.
Gender - hidden 3-27-19
Gender*
Race/Ethnicity*
Role in Organization*
If Role in Organization is "other" please describe role in a few words
Organization size*
How did you hear about this course? (please check all that apply)*
- Leadership Louisville Center (email, website, event)
- Mailed marketing material
- Community or professional event
- Suggested by employer/colleague
- Online or social media
- Traditional media (newspaper, radio, TV)
- Radio
- KYSHRM Conference
Terms and Conditions*
- Check this box to certify that you have read and understand the terms and conditions stated below.
Registration fee is non-refundable. If you are unable to attend the session for which you are registered, notify the Leadership Louisville Center immediately.
You will receive an email confirmation of this registration to your preferred email address.
Email
This field is for validation purposes and should be left unchanged.

Green Room Registration – Invoice

Green Room Registration – Invoice

Choose your course

Name and Title

Current Employment

Other information

You will receive an email confirmation of this registration to your preferred email address.

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