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* 1. First and Last Name

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* 2. Email Address

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* 3. Phone Number

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* 4. Current Title and Organization Name

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* 5. How many years of managerial or leadership experience do you have?

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* 6. What areas do you have experience in?

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* 7. By using the arrows, please rank each area you feel you need the most training. With the top one being the most critical and ranking the rest in descending order of importance for you.

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* 8. What are your career goals and motivation for applying to this program?

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* 9. What executive level do you aspire to?

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* 10. This program requires regular attendance (one absence allowed), active participation, and applied learning in-between sessions. Are you prepared to commit to this program?
Program dates: 8:30 am -3:30 pm -June 23rd, July 23, August 18th, September 17th, October 20th, November 17th
Fees:
Member $895
Nonmember $1195

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