Leadership Institute Registration

$350.00 each

Single Occupancy

Double Occupancy

First and Last Name	*
Roommate's First and Last Name (if Double Occupancy)
Address
City
State / Zip
Phone Number
Email Address	*
Club Name	*
District	*
# of Years in Lions
Have you previously attended a MI Lions Leadership Institute?	No Yes *
Which Institute do you Plan to Attend?	Leadership Emerging Lions *

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Business/Organization Name

2026 Lions Leadership Institute

Lions Clubs of Michigan
Wendy Burns, Executive Director

Address:
5730 Executive Dr., Lansing, Mi 48911

T: 517-887-6640 ext 103

F: 517-887-6642

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