Women's Leadership Council New Member Application

Women's Leadership Council New Member Form

Thank you for your interest in the Women’s Leadership Council! Please complete this form to indicate your interest and someone from the Women’s Leadership Council will contact you shortly.

Please note that information you submit via this form may be used to update your alumni record.

Name and Contact Information

First Name: Required Field

Last Name: Required Field

Primary E-mail: Required Field

URI Affiliation:

Preferred Class Year:

Major:

Phone Number: Required Field

Address 1: Required Field

Address 2:

City:

State:

Zip:

Employment Information

Job Title:

Employer:

Employer Address:

Employer City:

Employer State:

Employer Zip:

What interests you in the Women's Leadership Council? Required Field