Humanedge Application

Humanedge Application
Name*

First NameLast Name
Title*
Credit Union*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What are your goals for participation in this program? (e.g. Develop skills, build networks, expand emotional intelligence, gain a better understanding of the industry)*
What are your 3-Year Career Goals? (e.g. Become a CEO, Serve on an industry Board of Directors, Develop Strategic Planning Competency)*
Are you able to commit to attendance at both in-person events with the above dates and virtual coaching sessions (to be scheduled at mutually convenient times) throughout the 2025 program, with the intention of continuing into the second year of the program? (Yes or No) If no, what event(s) do you anticipate missing? *
Total Investment: $21,000 for the Two-Year Program.
- The Participant will pay Humanidei a TOTAL SERVICE CHARGE of $21,000 total ($10,500 annually).
- With the acceptance by Humanidei of this application, the Participant will pay Humanidei the full registration fee of $10,500 for the first program year.
- A second payment of $10,500 will be due in Year 2 of the program.
Signature*

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Title*
Date*

MonthDayYear
Date
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