ProInspire Leadership Institute (PLI) Registration

Your Work and Experience

Current Employer

Current Job Title

How many years have you been in this role?

Total years of full-time work experience as of today

Have you received any leadership or managerial training since becoming a manager?

YesNo

Of the following competencies/skills covered as part of the ProInspire Leadership Institute, which are you most interested in developing/would have the greatest impact on your leadership? (Please select all that apply. Scroll down the list to see all options. For multiple selection, hold down Command or Ctrl key.

Your Supervisor's Information

Supervisor's First Name

Supervisor's Last Name

Supervisor's Email

Your Background

The information you provide below will be shared with the other members of your Managing for Success cohort.

LinkedIn Profile Link

Bio (max 200 words)

Please upload a current headshot

This headshot will be included in your cohort's bio file and posted on the ProInspire website. Use the naming convention: LASTNAMEFIRSTINITIAL.JPG.

Your Payment

Are you able to commit to fully participating in each of the two workshops and completing all program prework/homework

YesNo

We have limited partial scholarships available to offset program fees for participants whose organizations cannot sponsor them. Would you like to be considered for a scholarship?

YesNo

Please upload an essay that answers the following two questions: 1) How much financial support are you seeking? 2) How will this program benefit you? Please keep this at maximum 300 words, and title the file "FirstName_LastName_Scholarship." If you are applying for a scholarship please choose the option to be invoiced while we review your application.

How will your program fee be paid?

Via credit cardPlease send an invoice

Discount Code

Please provide the name and email address of the individual who should received the invoice.

Post-Discount Total

Payment Information

Name on Card

Card Number

Code

Please enter the email address where your registration confirmation should be sent

You have reached the end of the application. By submitting you agree to our ProInspire Leadership Institute terms and conditions. Are you ready to submit?

Yes, my application is complete.

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ProInspire Leadership Institute (PLI) Registration

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