Registration Form

Please complete the registration form below. The following questions will help us to understand the needs of our audience in advance.
All workshops are 9:00 AM to 5:00 PM.  

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* 1. Personal Information

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* 2. Current Position:

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* 3. Previous Position

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* 4. Rank the importance of the following in your work:

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* 5. In which of the following areas are you seeking to gain new skills? Choose as many as may apply. 

I hereby grant Legacy International (LI) non-revocable permission to capture my image and likeness in photographs, videotapes, motion pictures, recordings, or any other media. I acknowledge that LI will own such images and further grant LI permission to copyright, display, publish, distribute, use, modify, print and reprint such images in any manner whatsoever related to LI. I further waive any right to inspect or approve the use of the image by LI prior to its use. I forever release and hold LI harmless from any and all liability arising out of the use of the images in any manner or media whatsoever, and waive any and all claims and causes of action relating to use of the images, including without limitation, claims for invasion of privacy rights or publicity.

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* 6. Please upload a resume if available. 

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 7. We want to know more about our participants as we prepare our Workshop for you. Please share with us your most successful endeavor.  

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* 8. What has been your most challenging experience? 

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* 9. What do you hope to accomplish professionally in the next five years?

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* 10. Photo/Video Release

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