More About Ethnic Outreach Activities

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LEAP Nomination Form

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Use this form to nominate yourself - or someone you are helping - for involvement in LEAP. When you click the "SEND" button, your information will be sent to LEAP, and you should be hearing from the LEAP Coordinator soon.

If you have problems with this form or would prefer to have one sent to you, contact Emily Davis at (206) 364-1613 ext. 125 .

Name

Phone Number (include area code)

Street and House/Apt. Number


City                                          State                               Zip

I live:

In my own house or apartment

With family

In a group setting with 2 or more housemates

I am interested in this project because:

I have the following advocacy and/or leadership experience:

I have the following support needs:

The Arc of King County • 10550 Lake City Way NE, Suite A, Seattle, WA 98125 • (206) 364-6337 (phone) • (206) 364-8140 (fax) • (206) 364-7438 (tty)
info@arcofkingcounty.org

A United Way Agency

Can't find the answer to your question here?
King County (Washington State) residents or those calling on behalf of someone in King County call the Information and Referral Hotline
at: (206) 364-8384 or toll-free (in Washington only) 1-877-964-0600
e-mail inforef@arcofkingcounty.org or use the online message form
-or visit-
Community Connections: A Resource Guide for Children and Adults with Developmental Disabilities

This page last updated: Thursday, April 17, 2008