Future Leaders Circle 2022 | Application Form

Thank you for your interest in joining the Future Leaders Circle.

To ensure the program is the right fit for you, please spend around 10-15 minutes completing this online Expression of Interest form.

Your answers will give me information about what you are looking for out of the program and help me to tailor the course content for the inaugural Circle group.

Whatever you submit is totally confidential and won’t be shared with anyone else.

And once you press SUBMIT at the end, I will be in touch in the next few days to set up a time to chat to you about the Future Leaders Circle.

Warm regards
Your Basic Information
Name*

First NameLast Name
Company Name*
Company Website*
Current Position/Job Title*
Email*
example@example.com
Mobile Number*
Please enter a valid phone number.
Your LinkedIn Profile link*
Which city, state and timezone do you work from?*
What is your best postal address?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Bio (a couple of paragraphs about your career so far)*
Summary of your experience in the industry
How long have you been in PR & Comms?*
Describe briefly your current role*
Are you managing people at the moment?

YesNo
If so, how many direct reports do you have? *
Have you done any study or training in Leadership?*

YesNo
If yes, please tell us a little about your training:

University levelManagement CertificateOther
Tell us more about any Leadership training you have done
Being Part of the Future Leaders Circle
Why would you like to be part of the 2022 Future Leaders Circle?*
What do you feel are the skills and attributes that future leaders will need to be Future Leaders? *
Does your current leadership style reflect the skills you believe a Future Leader will need? Please indicate where you feel you do and what skills you would like to develop.*
Program Participation

To achieve your goals and get the most out of the Future Leaders Circle, it requires your commitment and participation. Please have a read through these last few questions and answer yes or no:
I commit to attending Future Leaders meetings unless I am ill or have a personal emergency*

YesNo
I commit to preparing for meetings including; any complete any pre-work and readings*

YesNo
I commit to keeping all of our meetings confidential and not share anyone else’s details or information with anyone outside of the group*

YesNo
I am prepared to share my own experience with authenticity and candour during the program. And refrain from offering to anyone else advice :)*

YesNo
Thank you for completing the questionnaire. If you have any other comments please include here:
Should be Empty:

Your Basic Information

Summary of your experience in the industry

Being Part of the Future Leaders Circle

Program Participation