Corporate Innovation Course Registration Form
In order to register for the course please provide your answer to the questions below
1. Your Full Name *
Your answer
2. Your Linkedin Profile / Other online profile *
Your answer
3. Your Company *
Your answer
4. Industry *
Your answer
5. Your Company Website *
Your answer
6. Your Title *
Your answer
7. Country & City *
Your answer
8. Age *
Your answer
9. Number of years of experience in business / management *
Your answer
10. Your Goals at this Course? *
Your answer
11. Specific questions you are seeking to get answers to at this course ? *
Your answer
12. Describe your Current Agenda on Innovation today. (what is the current situation at your organization) *
Your answer
13. Indicate your proficiency in English *
14. Your city, country, timezone during the time period of the course *
Your answer
15. Preferred time for your online classes (in your timezone) *
16. How would you prefer to use your 2 hours of individual sessions: *
17. Would you like to order certificate for additional 50$? *
18. Your contact email: *
Your answer
19. Your contact phone number: *
Your answer
20. Let us know if you have any additional questions?
Your answer
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