Effective Executive Leadership Program: October 5-10, 2025

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* 1. First Name

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* 2. Last Name

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* 3. Phone Number

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* 4. E-mail

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* 5. Gender

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* 6. Birthdate

Date

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* 7. Street Address

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* 8. City, Province

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* 9. Postal Code

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* 10. Organization

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* 11. Job Title

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* 12. Industry

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* 13. Do you have any dietary restrictions?

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* 14. Education

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* 15. Education (2)

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* 16. Please indicate the level of your position within your organizational structure

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* 17. How many years of experience have you had in a management role

1 15 30+
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i We adjusted the number you entered based on the slider’s scale.
Note: 5+ years of experience in a management role is required.

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* 18. Number of staff reporting to you

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* 19. What are you hoping to get out of the Effective Executive Leadership Program?

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* 20. Please Provide the Authorizing Manager Information. This Manager may be contacted as part of the application process.

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* 21. Emergency contact information

Program Tuition: $8,700 + Taxes (Accommodations not included)

Once your application has been reviewed, you will be notified as to your acceptance via e-mail, which will include registration and payment instructions.

If you have any questions about this application process, please contact us.

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