Leadership Circles are open to individuals who work for nonprofits in Virginia. Leadership Circle Interest Form Name(Required) First Last Organization(Required) Professional Title(Required) Email(Required) Phone(Required)Organization's Address(Required)If you are not affiliated with an organization, please use your address. Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please choose the region in which your organization is headquartered. If no organization, choose your home region.(Required) 1 – Central Virginia 2 – Tidewater and Eastern Shore 3 – Northern Neck and Middle Peninsula 4 – Northern Virginia 5 – Charlottesville ( Blue Ridge and Valley) 6 – Western Virginia 7 – Southwest 8 – Southside Statewide Leadership Circle You're Interested In:(Required) Executive Circle Leaders of Color Circle
