B2 2019 Leader Roles Survey
Please complete the form below to help us organize the week for leader responsibilities. Contact Aaron (amalczewski70@gmail.com) with any general questions. Contact Kurt Wismer (wismerkurt@gmail.com) with any scheduling questions, technical questions or issues.

If any changes need to be made (change in attendance due to your work schedule, etc.) let Kurt Wismer know (wismerkurt@gmail.com).

Please complete this form as soon as possible. Our first meeting is March 16 at 10am at the Brigade building in Neenah.

General Contact Information
First Name *
Your answer
Middle Initial *
Your answer
Last Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Email Address *
Your answer
Primary/Preferred Phone Number *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Postal Abbreviation please (i.e. WI, IL, MO, AZ)
Your answer
Zip Code *
Your answer
Country *
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service