Leadership Council Member Information Form

Page 1

Leadership Council Member Information Form Name: ____________________________________________________________________________________ Address: _________________________________________________________________Zip______________ Phone:

(Home):________________________________

(Work):_________________________________

(Cell):_________________________________ e-mail address: ____________________________________________________________________________ Name of Business/ Organization: ________________________________________________________ Title: ______________________________________________________________________________________

Interest or Motivation with Early Childhood Initiatives:

Other Active Community Involvement:

Any Questions/Comments:

Vision: A diverse community where every family is supported and has access to quality programs and resources for their Mission: To help all children enter school healthy and young child. prepared to succeed.


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