Andar 360

Please complete this registration form in order to atttend the Leaders United Member Recruitment Night at Bosacki's Home Brew on December 5th from 6PM - 8PM Located at 610 East Hawley Street in Mundelein.

* First Name:

* Last Name:

* Address:

* City:

* State:

* Zip:

Employer:

* Personal Email Address:

* Work Phone Number:

* Cell Phone Number:

If you have any questions please contact:

Bobbi Selvik at 847.775.1022 or via email at Bobbi.Selvik@uwlakeco.org

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Leaders United Recruitment Night