Applications are received and Master Consultants are accepted without regard to race, creed, color, sex, age, national origin, marital status, physical or mental handicap, and veteran status. The receipt of this application does not mean that the applicant will be admitted to the Master Consultant Certification Program, nor does it obligate us in any way. We appreciate your interest in our organization.

If you have questions or trouble while completing this application, please email impact@growingleaders.com.

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* 1. Contact Information:

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* 2. Age:

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* 3. U.S. Citizen?

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* 4. Level of Education:

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* 5. Current Employer:

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* 6. Current Position:

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* 7. Does your organization have a website?

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* 8. If your organization is on social media, please list the URL addresses for each one below:

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* 9. If you are personally on social media, please list your URL addresses for each one below:

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* 10. Have you attended a Growing Leaders Habitudes Intensive Training Event in the past?

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* 11. Have you attended the National Leadership Forum in the past?

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* 12. What is the age range of the students and/or adults that you serve through your work?

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* 13. What is the legal structure of your organization?

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* 14. How many clients/customers/etc. do you currently work with? [This could be through speaking events, coaching, consulting, or sales]

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* 15. Is public speaking part of your current position or have you done it in past roles? If yes, please describe your speaking career.

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* 16. What percentage of your work is focused on developing young leaders?

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* 17. If your focus is less than 100%, what are the other areas of focus?

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* 19. In total, how many different young leaders did you invest in through the above methods in the last year?

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* 20. What leadership development resources are you currently using as a part of your work?

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* 21. What would your sales and marketing strategy be to promote your work as a Habitudes Consultant?

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* 22. Why are you interested in becoming a Habitudes Master Consultant?

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* 23. What are you looking to gain by being a Habitudes Master Consultant?

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* 24. Do you hold other types of certification? [i.e. Gallup StrengthsFinder, Myers-Briggs Type Indicator Practitioner, etc.]

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* 25. How would you want to incorporate the Habitudes content into your current work?

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* 26. Are you familiar with the Habitudes content?

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* 27. If yes, which books have you...

  Read? Taught?
Habitudes #1: The Art of Self-Leadership
Habitudes #2: The Art of Connecting With Others
Habitudes #3: The Art of Leading Others
Habitudes #4: The Art of Changing Culture
Habitudes for Communicators: The Art of Engaging Communication
Habitudes for the Journey: The Art of Navigating Transitions
Habitudes for Career Ready Students: The Art of Preparing for a Career
Habitudes for New Professionals: The Art of Launching Your Career

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* 28. List References: To apply for the Growing Leaders Master Consultant Certification Program, please contact three references to complete the Growing Leaders Master Consultant Reference Form. You can find this form at .... Please list his/her name, phone number, years you have known him/her, and your relationship to this reference.

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* 29. The Information I have given is correct and and may be verified by Growing Leaders if necessary. I understand that if I am accepted in the Master Consultant Certification Program, Growing Leaders reserves the right to disqualify me from the Master Consultant Certification Program for any reason it deems appropriate. I hear-by release and hold Growing Leaders harmless from all claims arising under this application. 
Please type your full name and date to serve as verification that you have read and understand the above paragraph.

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* 30. Please check the boxes below to note consent to the following requirements if you are accepted into the Habitudes Master Consultant Certification Program and decide to proceed with certification.

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* 31. Please check all of the following boxes. The check serves as a signature verifying that you understand the following are required before your application is considered complete.

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* 32. Please list any additional questions or comments:

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