Full Name
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First Name
Last Name
E-mail Address
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example@example.com
Phone Number
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City & State (We ask this to help coordinate live in-person intensives)
*
Linked In or Website
Organization/Business Name
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Title or Role
*
Which Market Place Academy Cohort are you applying for:
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The Emerging Leader Accelerator (August 2025)
The Sweet Side of 50: Reclaiming Influence Across the 7-Mountains (September 2025)
The Partnership Building Cohort (September 2025)
Which cultural mountain best reflects your current sphere of influence? (Select One)
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Business
Education
Media
Government
Arts & Entertainment
Family
Faith/Religion
Not Sure
What's one challenge you are currently facing in your leadership, business, or organizational growth?
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What do you hope to walk away with from this cohort experience?
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Why do you believe now is the right time to be part of this cohort?
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Are you prepared to invest the time (90-minute bi-weekly sessions + an in-person intesive) and resources into your growth during this 12-week intensive?
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Yes
No
Which of the following best describes your interest? (Select one)
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I'm ready to enroll
I'd like to speak with someone before committing
I'm exploring and would like more information
The next step is to schedule a 1:1 information session to discuss the cohort in more detail. Please select your preferred time window:
*
Morning
Afternoon
Evening
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