Shiloh Roberts - Optometrist - Kilgore-Gilmer Eye Care Centers

Youth Curriculum - Next Steps

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Contact Information*
First Last
Gender*
Age*
Are you currently an educator by profession?*
Organization*
Please provide us with the name of the school district you will be using iLead in.
Are you John Maxwell Team Coach*
Geographic Details*
City State / Province / Region Country
Email*
Phone*
Do you want to sponsor a virtual or an in-person group?*
Where do you plan to use the material?*
Maxwell Leadership Foundation uses attendance numbers to communicate iLead’s impact. Please be as accurate as possible. What is your beginning attendance for iLead?*
Please confirm your beginning attendance for iLead?*
Maxwell Leadership Foundation uses student enrollment numbers to communicate iLead’s impact. Please be as accurate as possible. What is the total number of students you are enrolling in iLead?*
Please confirm the total number of students you are enrolling iLead?*
Projected Start Date
MM slash DD slash YYYY
*
- I agree to not charge students for the printing or facilitation of this material
*
- I agree to the John Maxwell Leadership Foundation's Terms and Conditions.
CAPTCHA

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