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CLA Interest Form

Thank you for your interest in Community Leadership Academy (CLA). CLA is a program designed to help people with disabilities sharpen their leadership skills and help them get connected to boards, committees, and commissions to share their insight and expertise. Please complete the form below if you're interested in participating. We hope you'll join us to make real change in communities across South Carolina!

In order to participate, you must be an individual with a disability or a family member of an individual with a disability.
1.Name:(Required.)
2.E-mail:(Required.)
3.10-digit Phone Number:(Required.)
4.Town/City where you live:(Required.)
5.Tell us why you're interested in CLA:
6.In the past, have you ever served on a board, committee, or commission? If so, which one(s)?
7.Are you currently serving on a board, committee, or commission? If so, which one(s)?
8.What subjects are you passionate about (e.g. health and wellness, employment barriers, accessibility, a non-disability related topic)?
9.What, if any, are the organizations you're interested in?
10.Where would you like to get involved with leadership? What types of organizations do you want to serve?
11.Where would you be able to attend sessions (check all that apply)?(Required.)
12.Do you have a disability?(Required.)
13.Are you the parent of a child with a disability?(Required.)
14.Would you need any accommodations to fully participate in CLA?(Required.)