Community Leader Interest Form

First Name

Last Name

Title

Company Name

Email Address

Leadership Opportunities

Please select the CLOC Community leadership opportunities you are interested in (select all that apply).

Regional Group Leadership

Core 12 Learning Communities Leadership

Shared Interest/Affinity Group Leadership

Committee/Council Leadership

Statement of Interest

Please tell us a bit more about your interest in serving as a CLOC Community Leader.

Group Guide Acknowledgement

Please review and acknowledge the guidelines detailed in the CLOC Group Guide.

Send me a copy of my responses

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