Emerging Leader Initiative Application
Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Professional Information
Employer
*
Title
*
Total Work Experience
*
Please Select
1-2 years
3-5 years
6 or more years
Industry
*
Place of Worship
Highest Education Completed
*
Please Select
High School
Undergraduate
Graduate or higher
What leadership responsibilities do you currently have in the workplace? (Leading self, cross-functional, managing a team, etc...)
*
Why are you interested in being a part of the Emerging Leader Initiative?
*
Can you commit 4-5 hours each month into your growth and development? (This would consist of prework, 2 hour monthly meeting, 1 hour monthly meeting with your coach)
*
Please Select
Yes
No
I will pay $150 monthly for 7 months if I am accepted into ELI.
*
Please Select
Yes
No
On a scale of 1-7 how would you rate yourself in the following area?
I feel comfortable handling conflict in the workplace.
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Strongly Disagree
1
2
3
4
5
6
Strongly Agree
7
1 is Strongly Disagree, 7 is Strongly Agree
I manage my time and prioritize my work well.
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Strongly Disagree
1
2
3
4
5
6
Strongly Agree
7
1 is Strongly Disagree, 7 is Strongly Agree
I understand what it looks like to carry my faith into the workplace.
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Strongly Disagree
1
2
3
4
5
6
Strongly Agree
7
1 is Strongly Disagree, 7 is Strongly Agree
I feel I am a good communicator in the workplace.
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Strongly Disagree
1
2
3
4
5
6
Strongly Agree
7
1 is Strongly Disagree, 7 is Strongly Agree
What is one expectation or goal you have for yourself by going through the ELI program?
*
Share your testimony
*
As we pair our coaches and participants, we will look at several factors. If you are familiar with any personality profiles/tools (i.e. DISC, Working Genius, Strength, Myers Briggs, Enneagram, etc.) please share any traits or indicators so we can better match you with a coach.
How did you learn about the ELI program?
*
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