Become a Member

Memberships receive membership benefits instead of a tax receipt. If you prefer to receive a charitable tax receipt, please make a donation instead.

Yes, I want to help Leadership Waterloo Region develop the next generation of community leaders!

Contribution Amount

Visionary - $ 5,000.00

Innovator - $ 2,500.00

Partner - $ 1,000.00

Builder - $ 500.00

Ambassador - $ 250.00

Friend - $ 100.00

Other Amount

Other Amount $

Total Amount

I want to contribute this amount every

I am contributing on behalf of an organization.

On Behalf Of Organization

Organization Name *

Organization Email (General Mailbox) *

Your Information

Email *

First Name *

Last Name *

Current Employer

Street Address *

City *

Province *

Country *

Postal Code *

Phone

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Leadership Waterloo Region is a registered charity #88782 2617 RR0001.

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Become a Member

Thank you to our partners and sponsors!

Become a Member

Yes, I want to help Leadership Waterloo Region develop the next generation of community leaders!

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