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Immersive 10-month program for mid- to senior-level managers

Applications for the Impact San Diego Class of 2023 are due by 5:00 PM on Friday, June 17.

Please also review the Application Supplement as it has important information regarding the program and application process. If you have any questions, email Director of Programs Kim Van Nguyen.

Applications MUST be completed in one sitting. If you would like additional time to complete the application, you may download the Word version then copy & paste your answers on this form.

Cost:
Non members - $3,950
Chamber members - $3,555

Interviews are scheduled for Thursday & Friday, July 21 & 22, 2022.

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* 1. First Name

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* 2. Last Name

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* 3. Primary Email

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* 4. Alternate Email 

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* 5. Work Phone Number

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* 6. Mobile Phone Number

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* 7. City of Residence

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* 8. Zip Code of Residence

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* 9. Job Title

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* 10. Company Name

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* 11. Company Address

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* 12. Company City

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* 13. Company Zip Code

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* 14. How did you hear about Impact San Diego?

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* 15. Have you applied for Impact in the past?

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* 16. If yes, when?

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* 17. How many years have you lived in the San Diego/Northern Baja region?

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