Blue Hen Leadership Program Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Blue Hen Leadership Program Registration Form - Tier 2, The Engaged Leader

Welcome back to BHLP! Tier 2, the Engaged Leader, is open to those UD students who have completed Tier 1, the Established Leader.
By enrolling in Tier 2 you are taking the next step towards engaging in active leadership development.

Take The Journey, Dare to Lead.

UD Student ID *

First Name *

Last Name *

UD Email *

Cell Phone # *

Class Standing *

Gender *

Academic College *

College of Agriculture & Natural Resources

College of Arts & Sciences

Alfred Lerner College of Business & Economics

College of Earth, Ocean, and Environment

College of Education and Human Development

College of Engineering

College of Health Sciences

University Studies

Ethnicity

Africian American

Asian / Pacific Islander

Hispanic / Latino

Multiracial

Caucasian

Other:

Affiliation List all that apply *

Greek

RSO

Athletic Team NCAA

Club Sports

RA or other Res Life involvement

None

Other:

Required

Commitment *

Are you willing to commit to a two-hour monthly workshop/meeting throughout the academic year in order to accomplish the Engaged Leader activities? Every effort will be made to schedule the workshops to accomodate the majority of participants.

I can commit time once a month.

I am unable to commit.

I am unsure at this time.

Primary Goal *

Please explain your primary goal(s) in continuing your participation in the BHLP:

I will attend the fall retreat for Tier 2, Spet 28-Sept 30, 2012, in St. Michael's, Maryland. *

I understand that by checking "yes", I am agreeing to pay the required $50 cost, in two payments of $25, one due by May 25th and the second due by Sept. 28th

Yes, I will attend the retreat

No, I will not attend the retreat

Submit

Clear form

Never submit passwords through Google Forms.

Forms

This form was created inside of University of Delaware.