LanceWinslow@LanceWinslow.org
You may use this short form below and if you appear to
qualify to run an International Think Tank in conjunction with the Online
Think Tank we will later mail you the long form.
You may cut and past this form into an email and simply answer the questions
below. We thank you in advance for your consideration.
International Think Tank Short Form
1. Name:
2. E-mail Address:
3. Address, City, State, Country:
4. Fields of Knowledge and areas of Expertise:
5. Contributions to Society, Industry, Government:
6. Contributions to Community:
7. Academic Credentials:
8. Reason for Interest:
9. How did you hear about us: