Thank you Thank you for expressing your interest in atending Athlete Leadership University. This form is to collect contact information and learn what Athlete Leadership University course(s) you are interested in completing. 

Please note that this is NOT a registration form for Athlete Leadership University. Instead, this allows Special Olympics Pennsylvania to get the word to more athletes. In order to register, you will still need approval from your Program Manager & Regional Executive Director.

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* 1. First and Last Name 

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* 2. Local Program

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* 3. Select the Athlete Leadership University Course(s) you are interested in completing.

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* 4. What is the best phone number to reach you at?

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* 5. What is the best email address to reach you at? (If you do not have a personal e-mail address, please give the e-mail address of your parent/guardian or another person that will share e-mail communications with you.)

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* 6. Do you have someone committed to serve as your Mentor?

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* 7. If you answered, "yes", please provide their full name, phone number, e-mail address and relation to you. 

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