THE BJX LEADERSHIP 6 WEEK COURSE ROUND VI

LEARN NEW THINGS. MEET POWERFUL CEO'S. ENJOY GREAT CAMARADERIE. EARN $300. RECEIVE A CERTIFICATE.

First name?

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Last name?

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Your email?

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Who referred you?

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Whats your cell #?

We may need to reach you. We promise that we won't share it:-)

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What college do you attend?

Please specify. Tell us what year you're in.

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Is your mother Jewish?

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Which High School(s) did you attend?

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What are your hobbies? Did you receive any awards/scholarships?

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We require that you submit a recent photo of yourself. Please submit it now.

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Please type your full address and your d/o/b

All info is kept strictly confidential.

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Please join our Group

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By applying for the Leadership course I agree to attend the Mega New Year's Dinner(Sep 20)

Failure to attend will disqualify you from receiving your $300 stipend.

By checking this box I understand that I have to attend the Sep 20th Dinner to receive the stipend

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By applying for the Leadership course I agree to attend one local Weekend with the CEO's

It will take place in Flatbush. Failure to attend will disqualify you from receiving your $300 stipend.

By checking this box I understand that in order to receive my stipend I have to attend the three Gourmet Meals & Exclusive Weekend from Friday evening-Saturday night with the CEO's.

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