Home     About Leadership Kansas              Board of Trustees     Distinguished Leaders      Class Rosters     LK News     Kansas Is...     Sponsors     Alumni Events     Update LK Directory Info     Contact         2011 Class Nomination Form                         2011 Leadership Kansas Nomination Form I nominate the following individual, whom I consider to be an excellent candidate, to receive an informational packet and application for the 2011 Leadership Kansas Program. Information regarding this nomination will be sent to each nominee at the close of next year’s nomination process. First Name * Last Name * Address * City * Zip * State * AL AK AR AZ CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY E-mail * Occupation * Gender* Male Female Race/Ethnicity* African American American Indian Asian Caucasian Hispanic Other *This information is used to help achieve a group representative of the entire state. Your Name * Company * Address * City * State * AL AK AR AZ CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip * Email *               John Federico, J.D. Leadership Kansas Executive Director (785) 290-0017 leadershipks@fedconsulting.kscoxmail.com

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