APPLICATION FOR THE CHINOOK PROGRAM

Please fill out the application below. Contact us with any questions.

Cancellation Policy

The Chinook Institute for Civic Leadership provides a 50% refund on all registrations canceled 30 – 60 days prior to the event. Cancellations between 30 days and 5 days before the start of the event will have a 25% refund. Cancellations less than 5 days before or during the event will not receive a refund. Substitutions are generally acceptable.

Name (as you want it on your nametag and the roster)

First Name

Last Name

Email Address

Title

Organization

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

List most recent professional positions, elected offices, professional and civic activities, and awards.

By selecting the checkbox below, I acknowledge the accuracy of the information, understands the cancellation policy, and agree to stay for the entire six-day residential session.

I agree