Leadership Training Program Application Form



YES! Enroll me!My check for $25.00 (includes LRB) payable to "Sierra Club" is enclosed.

Check the session you desire:
___ Spring Sem. (Griffith Park), Apr 3, 2004
___ Fall Sem. (Loc. TBD), Oct 16, 2004

Name ____________________________________________________________________

Address _____________________________________________________ Apt. # _______

City _______________________________ State ________________ Zip ______________

Phone Contact: __________________________ Email:_____________________________



Mail to: Steve Botan, LTC Registrar, 18816 Thornwood Circle, Huntington Beach, CA 92646
Phone: 714-963-0151



Angeles Chapter - Sierra Club
Revised: 12/5/2003