Adult Lead Registration

Registration for Adult Leads identified/assigned by network partners. Adults Leads have dedicated time and passion for engaging learner cohorts through the Midwest Learner Design Summit experience, alongside a fully committed university team. 

This information will help us prepare for the Summit experience. Questions? Contact rep4@gvsu.edu. 

* denotes a required field

Partner Organization Information



Emergency Information

Accommodations

GVSU will provide reasonable accommodations to individuals with disabilities upon request. For questions about accessibility please contact rep4@gvsu.edu.


Additional Forms

Complete, save, and upload each form:

Media Release

W-9

An electronic authorization for release of information background check will be sent to your email following registration. 


Gender Identity (Please select all that apply): *











Commitment Review




Page last modified June 22, 2021