Women and Power Application

Women and Power Application

Applications will be accepted until October 30, 2018. This program is an advanced leadership skill program open only to Polk alumni.

Applications will be accepted until October 30, 2018. This program is an advanced leadership skill program open only to Polk alumni.

 

 

 

answer must be phone number with area code like 217-333-1000

 

answer must be an email address

 

required7. What is the best way to reach you?

required7. What is the best way to reach you?

answer must be numeric

 
limited to 4 characters.

Please answer N/A if you are not affiliated with a Union

Please answer N/A if you are not affiliated with a Union

 

Please answer N/A if you are not affiliated with a union

Please answer N/A if you are not affiliated with a union

 

required11. Do you want to opt-out of our contact list to receive information about future events, course and program offerings? You can always opt-out of our contact list in the future by contacting our program and requesting to be removed from it.

required11. Do you want to opt-out of our contact list to receive information about future events, course and program offerings? You can always opt-out of our contact list in the future by contacting our program and requesting to be removed from it.

OPTIONAL QUESTIONS:

12. What is your race/ethnicity?

12. What is your race/ethnicity?

13. You identify your gender as...

13. You identify your gender as...

14. Have you previously enrolled in a Labor Education Program class/seminar

14. Have you previously enrolled in a Labor Education Program class/seminar

Check all that apply

15. How did you hear about the Labor Education Program?

15. How did you hear about the Labor Education Program?

Check all that apply