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Professional Membership Form
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Yearly
Contact Information
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First Name
Last Name

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Address Line 1
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The following will be used in the MNDC Directory: 

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As a professional member, you have an option be listed on our Speakers Bureau page. If you are interested, please list the general topics you speak on. Limit 1-5 topics.
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The following information will NOT be posted in the MNDC Directory: 


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** The information collected below is anonymous and will be aggregated so that no personal information is connected with your answers. This cumulative data is used for grant requests, programming strategy, and diversity, equity, and inclusion efforts. Thank you in advance for your willingness to participate. 

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"By clicking the box below, I am indicating that I understand and accept the following terms: 1) Inclusion of my information on the website directory does not constitute endorsement by MNDC or my training organization, if I have one. 2) I am fully responsible for my own contracts, promotion, and interaction with the public. 3) I have read and understand the MNDC Mission, Vision and Value statement. 4) I understand that my listing on the website directory will only be included as long as I am an active member of MNDC (renew each year).”