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* 1. What is your full name?

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* 2. What is your position and the name of your organization?

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* 3. Have you previously taken leadership training? 

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* 4. What is your preferred method of learning? 

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* 5. What is your preferred time of day for training? Check all that apply. 

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* 6. What personal leadership areas would you like to improve? 

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* 7. Please rank the following leadership competencies based on need for improvement within fire services? (1st will have the greatest need for improvement, 13th will have the least need for improvement).

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* 8. If you were to participate in a program which level would be most suitable to enroll in? If your organization does not use these titles, please select the one that most closely aligns with yours.

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* 9. If you were to have your direct reports participate in a program which level would be most suitable to enroll in? If your organization does not use these titles, please select the one that most closely aligns with yours.

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