Empathy 4 Impact Women's Leadership Series Application

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Please complete this three-step application to apply for the Women's Leadership Series. We read every application personally.

Step One: About You

First and Last Name *

Email Address *

Phone Number *

Organization Name *

Title / Role

Sector *

How did you hear about this program? *

Years in a leadership role *

0 to 2 years

3 to 5 years

6 to 10 years

11 to 20 years

20+ years

Step Two: Your Leadership Context

What is bringing you to this program right now? *

What would change for you if this program delivered everything you hoped for? *

Is there anything about your leadership context you want us to understand? *

Which cohort format are you interested in? *

Open cohort (mixed organizations)

Corporate cohort (closed, single organization)

Not sure yet — I would like to discuss

Step Three: Commitments

This program is intentionally small (8 to 12 women) and requires full participation. Please read each statement before confirming.

Application Commitments *

I confirm and agree

I understand this is an application, not an enrollment. Submitting does not guarantee a seat.

I am committed to full participation across the 90-day cohort, including all group sessions and both private coaching calls.

I understand that cohort members are expected to show up with honesty, generosity, and respect for the shared space.

I agree to receive communications from Empathy 4 Impact about this program and related offerings.

I confirm and agree

I understand this is an application, not an enrollment. Submitting does not guarantee a seat.

I am committed to full participation across the 90-day cohort, including all group sessions and both private coaching calls.

I understand that cohort members are expected to show up with honesty, generosity, and respect for the shared space.

I agree to receive communications from Empathy 4 Impact about this program and related offerings.

Submit

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