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LD Board Opportunity Form

Personal Information
All information required unless otherwise noted

Your Name

Title

Company

Email

Phone

Leadership Detroit Class

Organization Information

Organization Type

Name

Industry/Sector

Address

City

State

Zip

Contact Name (if different from above)

Contact Email (if different from above)

Contact Phone (if different from above)

Annual Revenue

Mission Statement

Website

Number of Total Board Members

Meeting Frequency

Skills Required

Expectations

Responsibilities

Restrictions