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* 1. First name:

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* 2. Last name:

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* 3. Job title:

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* 4. Company:

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* 5. Talk to your line manager to agree up to three personal learning objectives that set out clearly how you want to develop by attending the Black Belt Program. Please list your personal learning objectives below and also bring a copy with you to the training:

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* 6. Write a short biography to introduce yourself to your fellow course participants - no more than 250 words that summarise your role and professional background. Think about the type of information you’d like to know about other delegates, and write your biography with this in mind. When you register on the first morning of the course, we’ll give you a delegate list containing a short biography about each person.

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* 7. Are you happy for your email address to be shared with your fellow course participants? We’ll circulate everyone’s contact details immediately after the course to facilitate your networking.

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