Leadership Mastermind Application

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Thanks for your interest in the Leadership Mastermind with Mark Aardsma and David Martin. The event is April 20th and 21st, 2015 in Houston, TX. Please fill out this application honestly. We'll use your responses to help us fill the event with the best-fit participants, and to customize the content to create the most value. Your responses will be kept confidential. Applications and invitations are on a first-come first-serve basis. Once we have selected a full slate of participants we will confirm registration details.Thanks!

Your First and Last Name

Best Email Address to Reach You

Best Phone Number to Reach You

Please describe the work you are doing.

Please tell us about your goals and ambitions.

Please tell us about your challenges and obstacles.

What are three things you'd like to learn about at the event?

What's something other participants in the event could learn from you?

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