LEAP Application 2020
Thank you for your interest in IIBN New York's Leadership & Executive Acceleration Program (LEAP)™. Please fill out this form and we'll be in touch with you shortly. Please note that incomplete applications will not be processed.

Applicants are screened by a selection committee of LEAP and IIBN Board members. The selection process is competitive and space is limited. We seek diversity of sector and skill-set. LEAP is ideal for applicants in mid-career who are currently employed or run their own business entity. Must demonstrate a commitment to LEAP in the Community.
Email address *
First Name *
Your answer
Last Name *
Your answer
Address Line 1 *
Your answer
Address Line 2 *
Your answer
City, State, and ZIP *
All applicants must reside in the Greater New York City Area
Your answer
Preferred Phone Number *
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LinkedIn URL
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Are you Irish or Irish-American? *
Please outline any other Irish-related businesses, alumni or networks you are a member of:
Your answer
Please list any educational institutions you have attended, qualifications and years of attendance and professional certification:
Please include any relevant colleges, universities, adult education programs, etc. and graduation year for each.
Your answer
What is your area(s) of expertise? *
Required
How many years of experience do you have in your area of expertise?
Please select your current industry or business sector *
What is your employment status? *
Which company or organization do you work for?
Your answer
What title do you hold at your company or organization?
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Please provide your Twitter handle or similar social media account.
If you’re not a big social media user, don’t worry. Fill in what you can.
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