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* 1. Preferred Name

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* 2. UNM e-mail address

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* 3. How did you hear about ULead

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* 4. Current Title

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* 5. Department Name

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* 6. Work Number / Extension

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* 7. Direct Supervisor's Name

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* 8. Direct Supervisor's email

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* 9. What got you interested in the ULead program?

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* 10. Which of the learning pathways are you interested in completing this fall?

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* 11. Additional comments or questions

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* 12. ULead is an intense leadership development program which will occur on eight consecutive Wednesdays (March 11, 2020 - April 29, 2020). Participants will have a project and other work that might require work outside of the classroom. Attendance at all sessions and completion of the program project is mandatory.

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* 13. I understand that both participant and supervisor have a role in making participation successful. I acknowledge I have discussed this with my supervisor and we agree to the time commitment and course requirements.

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