Online Registration

Thank you for your interest in joining us for CLI. Please note that the program fee ($5400) covers your registration, all conference events and materials, and meals during Phases I and III of the program. Placement in the program is not guaranteed until payment is received, due upon receipt of invoice and no later than 45 days prior to the start of the program. Cancellation within 45 days of the program will require a forfeiture of 50% of the program fee.

Lodging is paid directly to the conference hotel. CLI is a comprehensive program and participants are required to stay at the selected facility. You will receive information about booking your room once your registration and program payment is received.

Participant Name:

First Name

Last Name

Participant Email Address:

What gender do you identify with?

Select CLI Program

Name of your Organization

Your Title

Organization's Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Participant Cell Number:

(###)

###

####

Supervisor's Information

Supervisor's Name:

First Name

Last Name

Supervisor's Email Address:

Billing Information

Please provide an EMAIL address for billing:

Your Background

Briefly describe your employment/technical background:

(i.e., production, sales, accounting, general business, government, nonprofit, etc.)

What management, communication and/or human relations type courses have you taken?

(past five years only)

Are you now, or have you in the past year, participated in any personal counseling/therapy?

Do you have any medical/dietary restrictions?

(Please list your restrictions below)

Who referred you to our program?

First Name

Last Name

Additional Comments

Your Leadership Goals

The goals you list below will be shared with CLI staff so that they can better understand your learning objectives. Please meet with your supervisor (as appropriate) and jointly determine 3-5 areas where you feel your leadership can be strengthened.

Goal #1

Goal #2

Goal #3

Goal #4 (optional)

Goal #5 (optional)

Register

Online Registration