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Name *

First Name

Last Name

Business Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

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Agreement & Commitments *

We will meet 10 times in person and 2 time virtually over the course of 12 months (approx 50 hours). Can you commit to attending monthly meetings?

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

We will commence with a full day retreat on May 8 in Newport Beach. Can you commit to attending the retreat in person?

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Students will be asked to complete course work outside of meeting hours. Can you commit to course work between sessions which will require self reflection in order to meet your goals?

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Students will have access to senior industry leaders, as well as industry peers. Can you commit to showing respect and kindness to all participants?

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

At times students will be invited to join networking events, panels or tours after their monthly meeting. Can you commit to attending most events and using the time to interact with classmates as well as other industry leaders and peers?

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree