Leadership Mississippi Acceptance form 2024

Leadership Mississippi 2024 Acceptance Form

Please submit this form by January 19, 2024, to confirm your acceptance and agreement to the terms and conditions outlined above.
Leadership Mississippi Class of 2024 Terms & Conditions Acceptance*
- I agree to attend the sessions included in the acceptance letter unless a demonstration of an extraordinary circumstance prevents me from participating on those dates.
- I recognize that any unexcused absence or failure to timely comply with the notice requirements of the Excused Absence Policy may constitute a basis for participant removal from the class.
- I acknowledge that participating in all program activities is solely my own initiative, risk, and responsibility.
- I agree that Leadership Mississippi may use any media footage with or without my name and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and Web content. I give this authorization without the expectation of compensation.
- I agree to ensure the $3,500 Leadership Mississippi program tuition is paid on or before February 21, 2024.
- I acknowledge that the tuition fee for the program is non-refundable. In the event of withdrawal from the program or dismissal due to attendance, the tuition fee is not subject to refund.
- I do not accept the invitation to participate.
By signing this agreement, I confirm that I have read and understood the attendance requirements, financial obligations, and agree to comply with the terms and conditions stated above.
First Name*
First
Last Name*
Last
Maiden Name
Last
Company*
Title*
Address 1*
Address 2
City*
State*
Zip*
Phone*
Email*
Electronic Signature*
Full Name
Please type your full name into the box above. The entry of your name represents your digital signature; you have read the above terms & conditions, accepted the terms and conditions, and the invitation to participate in the Leadership Mississippi Class of 2024.

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Leadership Mississippi 2024 Acceptance Form

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