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Leadership in Ethnically Diverse Communities (LEDC) Application

Blandin Foundation Leadership Programs does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, selection of volunteers including program participants and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all members of our staff, participants, volunteers, independent contractors, and vendors.

Tell Us About You

First Name

Preferred First Name

The first name you would like to appear on your name tags

Last Name

Home Mailing Address

Home City

Home State

2 character limit

Home Zip/Postal Code

Personal Email

Work Email

Preferred Email

Home Phone

Work Phone

Mobile Phone

Preferred Phone

Gender

Birthdate (must be at least 18 years of age to participate)

MM/DD/YYYY

Employer (if applicable)

Occupation/Kind of Work

Race/Ethnicity (select all that apply)

African American/Black

American Indian/Native American

Asian

Caucasian

Hispanic/Latino

Pacific Islander

Other Race/Ethnicity

Why would you like to participate in the LEDC program?

Have you applied for or participated in a Blandin Foundation training or event in the past?

Your answer to this question will not affect your participation in the LEDC program.

The Blandin Foundation reserves the right to rescind any invitation to participate in any of its programs up to, and during, the program.

Questions? Call Becky Adams at 1-877-882-2257 Ex 736 or send her an email .

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