*Agency:

*Address:

*Contact Person:

*Phone:

*E-mail:

Fax:

See information sheet entitled “Women’s Leadership Circles, A Brief Overview” (on iWIL website: http://www.brescia.uwo.ca/iWIL/community/index.html):

* a) Describe the needs of the prospective participants.

* b) How do you envision the Leadership Circle will address those needs?

* c) When would you like to schedule the meetings?

* d) Where would you like to meet?

* e) What help do you need from iWIL?

Additional Comments: