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CEO 2.0 Innovative Leadership Course Registration Form
In order to register for the course please provide your answer to the questions below
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* Indicates required question
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?
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Your answer
11. Specific questions you are seeking to get answers to at this course ?
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Your answer
12. Describe your Current Agenda on Innovation today. (what is the current situation at your organization)
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Your answer
13. Indicate your proficiency in English
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Native Speaker
Fluent
Intermediary
Other:
14. Your city, country, timezone during the time period of the course
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Your answer
15. Preferred time for your online classes (in your timezone)
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Morning
Afternoon
Evening
Other:
16. How would you prefer to use your 2 hours of individual sessions:
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Strategy Consulting
Leadership Coaching
17. Would you like to order certificate for additional 50$?
*
Yes
No
18. Your contact email:
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Your answer
19. Your contact phone number:
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Your answer
20. Do you have additional questions?
Your answer
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