Registration

Registration for Leadership On The Line^® and Stepping Up to Leadership^sm
We will use the information on this form as a reference throughout the process, so please take the time to fill in all of the information below. Which course are you registering for? Leadership On The Line^® Stepping Up To Leadership^sm
I. Personal and Professional Information
Your Name:
Title:
Organization:
Email:
Business phone:
Emergency phone:
Years in a management role:
Years in current position
No. of people you supervise:
Immediate manager's name:
Title:
Telephone:
Email:

II. Your Views on Leadership
As a leader, what are 3 key areas or frustrations on which you want to focus your learning?
Have you participated in other formal leadership development programs? If so, please describe:
Why are you taking this leadership course?
What are your expectations of this leadership development process? What do you hope to learn?
Please describe the essential work of your group.