Leadership Training Registration Form
Register now to participate in the Executive Leadership Training and enhance your leadership skills.
Personal Information
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number (WhatsApp preferred)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Gender
*
Female
Age Bracket
*
Please Select
25–34
35–44
45–54
55+
Prefer not to say
County/City of Residence
*
Nationality
*
Professional & Leadership Background
Current Occupation / Professional Role
*
Organization / Institution / University
*
Sector of Work / Engagement
*
Please Select
Education
Nonprofit / NGO
Government
Private Sector
Healthcare
Religious Organization
Community Development
Media / Communications
Student
Other
Do you currently hold a leadership position?
*
Yes
No
If yes, please briefly describe your current leadership role(s)
*
Years of Leadership Experience
*
Please Select
Less than 1 year
1-2 years
3-5 years
6-10 years
More than 10 years
Motivation & Expectations
Why are you interested in participating in this training?
*
What leadership challenge(s) are you currently navigating?
*
What do you hope to gain from this program?
*
How do you intend to apply the knowledge and skills gained after the training?
*
Participation & Logistics
Dietary restrictions or accessibility requirements
*
How did you hear about this training?
*
Please Select
Organization email
Social media
WhatsApp
Colleague or friend
Website
Flyer or poster
Other
Payment Confirmation
Please enter your payment details below. Investment fee for 2 days is KES 10,000. Payment done through Paybill Number 522522Account No. 1351343092
MPESA confirmation code
*
Consent & Declaration
Consent to Photography and Media Documentation
*
Yes, I consent
No, I do not consent
Submit Registration
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