Leadership Academy Membership Form | School of Education

Register for Membership: 2025–2026

Comprehensive membership dues are $475 for the 2025-2026 year. This membership includes attendance for multiple people.

Select Your Membership Level

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Membership Season

Membership Selection(Required)

Please select your membership level

Leadership Academy

Monmouth University Student/Faculty

Membership Dues Cost:

Registrant Information

Please provide accurate contact information for the person completing this membership form. If applicable, the registrant will receive an invoice via email and will be the main contact for any billing inquiries (unless you specify otherwise).

Name(Required)

First Last

Title(Required)

Email(Required)

Phone(Required)

Is the registrant the best person to contact for any invoices, inquiries, or updates?(Required)

Yes

Best Contact's Name(Required)

First Last

Best Contact's Title(Required)

Best Contact's Email(Required)

Best Contact's Phone(Required)

School Information

School

Monmouth University

School District(Required)

County(Required)

Address(Required)

Street Address City State ZIP Code

Attendee Information

How many people will attend the academy?(Required)

Please enter a number greater than or equal to 1.

Please Note: you are indicating that you would like to register more than eight (8) attendees. After you submit the form, we will reach out to you (or the person you listed as the best person to contact) for a list of the attendees.

Attendee #1

Attendee Name(Required)

First Last

Title(Required)

Email(Required)

Attendee #2

Attendee Name(Required)

First Last

Title(Required)

Email(Required)

Attendee #3

Attendee Name(Required)

First Last

Title(Required)

Email(Required)

Attendee #4

Attendee Name(Required)

First Last

Title(Required)

Email(Required)

Attendee #5

Attendee Name(Required)

First Last

Title(Required)

Email(Required)

Attendee #6

Attendee Name(Required)

First Last

Title(Required)

Email(Required)

Attendee #7

Attendee Name(Required)

First Last

Title(Required)

Email(Required)

Attendee #8

Attendee Name(Required)

First Last

Title(Required)

Email(Required)

Payment Information

Total Amount Due

Is Your Purchase Number Available?(Required)

Yes

Purchase Order Number(Required)

Since you indicated your Purchase Order Number is available, please provide in the available field.

Phone

This field is for validation purposes and should be left unchanged.