Center for Leadership Development

CLD/LILLY Youth Summit

Lilly Corporate Center

Saturday October 18, 2008

Student Name:
High School Attending:
Current Grade Level:
Telephone #:
Address:
City, State & Zip Code
Student Email Address:
Indiana College/High School/Universities of interest:
Parent(s) Name		Telephone #:
Parent Email Address:
Will they be attending?	Yes No

Please let use know if you are a vegetarian or will need handicap access

	Vegetarian
	Handicap Access

To mail registration and payment send to:

Center for Leadership Development

3536 Washington Blvd.

Indianapolis, Indiana 46205-3719

(317) 923-8111

ATTN: Robin Andrews

www.cldinc.org

Center for Leadership Development
3536 Washington Blvd.
Indianapolis, IN 46205-3719
(317) 923-8111