Experience St. Louis Registration

Register

Experience St. Louis Registration Form

"*" indicates required fields

Registrant Type

Executive Only

Executive Spouse/Partner

Executive Contact Information

Executive Name

First Last

Title/Position

Employer/Organization

Email*

Preferred Address

Home

Work

Home Address

Street Address Address Line 2 City State ZIP Code

Work Address

Street Address Address Line 2 City State ZIP Code

Preferred Phone

Phone Type

Home

Work

Mobile

Executive Demographic Information

Date of Birth (mm/dd/yyyy)

Gender

Which categories describe you?

Select all that apply.

American Indian or Alaska Native

Asian

Black or African American

Hispanic, Latino or Spanish origin

Middle Eastern or North African

Multi-Racial

Native Hawaiian or Pacific Islander

White/Caucasian

Some other race, ethnicity or origin

Do you have any dietary restrictions? If so, please indicate:

Do you require any special accommodations? If so, please describe your needs:

Spouse/Partner Contact & Demographic Information

Name of Spouse/Partner

First Last

Title/Position

Employer/Organization

Email

Date of Birth (mm/dd/yyyy)

Gender

Which categories describe you?

Select all that apply.

American Indian or Alaska Native

Asian

Black or African American

Hispanic, Latino or Spanish origin

Middle Eastern or North African

Multi-Racial

Native Hawaiian or Pacific Islander

White/Caucasian

Some other race, ethnicity or origin

Do you have any dietary restrictions? If so, please indicate:

Do you require any special accommodations? If so, please describe your needs:

Program Tuition

Tuition for the program is $800 for an executive or $1400 for a couple. Fees include one-year membership in FOCUS St. Louis and are often paid by employers.

Payment Preference

Invoice me

Invoice my employer

Pay by credit card

Credit card payments may be processed online here.

Subscribe

Yes, I'd like to receive emails about upcoming FOCUS events, civic engagement opportunities and programs.

“Even though I’d been here for a few months before I went through the program, it provided information that was almost entirely new to me. There is no better way to learn so much so quickly about this community and have fun at the same time.”

Kimberly Walker

Chief Investment Officer, Washington University in St. Louis
Experience St. Louis 2007