MN LDEI Membership Application

Name *

First

Last *

Last

Company/Business and Title *

Work Phone

Home Phone *

Cell Phone

Email *

1. Why I would like to become a member: *

2. My relevant industry experience in the last five years (attach resume if you have one): *

Attach Resume

Maximum upload size: 134.22MB

3. What other skills do you possess that can help further the goals of the LDEI philanthropic organization: *

4. Areas of interest for committee work (check all that apply): *

5. What are you hoping LDEI will bring to you personally and professionally (check all that apply): *

Mentorship

Networking

Philanthropic Opportunities

Other (please specify goal)Other (please specify goal)

6. I understand the introductory and annual dues financial commitment of $175/year. *

Yes

No

7. I am interested in receiving financial aid information for membership dues payment.

Yes

No

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Membership Application