Leadership Application

Pennsylvania

LifeSharing

Coalition

The mission of the Pennsylvania Lifesharing Coalition is to promote, support and embrace the concept of Lifesharing and the philosophies of self-determination and everyday lives.

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2023 LifeSharing Conference
Leadership Application

Why are you interested in becoming part of the Lifesharing Leadership team?

Length in Position: *

Please highlight your top three goals for expanding Lifesharing awareness and services in the state of Pennsylvania: *

Before submission of this application, please confirm your agency’s leadership support and approval of this application to join the state Lifesharing Leadership team.

All applications must be received by 3/1/24 for consideration.

Please describe your philosophy of the Lifesharing Service: *

Phone Number: *

How long has your agency been providing Lifesharing Services? *

Length in Lifesharing *

Regions of Interest *

Western

Central

Northeast

Southeast

Do you have the ability to attend statewide Lifesharing Coalition meetings 1-2 days every other month (this may include 1-2 days of travel)? *

Yes

Agency Name: *

Name: *

Do you have the ability to attend impromptu virtual meetings with the leadership team as needed? *

Yes

Do you have the ability to participate in hosting and facilitating regional Lifesharing meetings in the opposite months of the statewide meetings? *

Yes

Company Email Address: *

Job/Position Title: *

Do you currently attend the Lifesharing Coalition meetings? *

Yes

Thank you for contacting us! If needed, you will hear back within 48-72 hours.

Pennsylvania LifeSharing Coalition

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