* 1. I want a career/next step that contributes to the betterment of the world more than my current job does.

* 2. I would like to explore more meaningful, purpose-driven career options.

* 3. I would like to start a socially responsible business, or work for a more socially responsible company, but need to know more about my options.

* 4. I am afraid to make a career change due to:

* 5. I would like the following help in considering my next move:

* 6. I’d attend a program that lasted 2 days (Friday evening to Sunday noon) and had the following topics: (white box)

* 8. What else would you like to share with us concerning these topics that will assist us in planning a great program?

* 9. Would you like to know more about the program when it is open for registration? Please provide your name and email address below.