Leadership360 Program/Committee
Name
First Name
Last Name
Job Title
Organization
Email
example@example.com
Years in Industry
Why are you interested in participating in the Leadership360 Education Series?
What leadership challenges are you currently facing that you hope this program will help you address?
Which of the six leadership elements most resonates with you right now, and why? Inspiring Excellence - Managing for Results - Promoting Collaboration and Teamwork - Encouraging Individual Achievement and Growth - Supporting Critical Thinking and Consensus BuildingPersonal and Professional Development
The program requires attending six sessions over the course of the year. Can you commit to participating in all sessions? (Yes/No)
Yes
No
How do you plan to apply what you learn in your role or organization?
Signature
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