2022 Eno/MAX Enrollment

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Email *

First Name *

Last Name *

Organization Name *

Eno/MAX Program Year Attending *

Gender *

Age *

Check the category that best describes your identity (check all that may apply) *

American Indian/Alaska Native

Asian

Black or African American

Hispanic/Latino

Native Hawaiian/Pacific Islander

White

Prefer not to say

Other:

Required

Job Title *

Position Description - What are your responsibilities? *

Name and description of your department *

Is your position represented by a Union? *

Yes

How many direct reports do you have? *

Zero

1-10

11-25

26-100

101-200

201+

Are any of your employees represented by a Union? *

Yes

Functional Area *

Other Area:

Work Phone *

Cell Phone (For real time information during the host week) *

Do you have access to a work computer where you could attend conference calls or webinars? *

Yes

If no, describe what is available. If yes, enter N/A. *

What other leadership programs have you taken in the past, if any? If none, please enter N/A. *

Formal name for certificate at graduation *

Preferred name for badge and table tent (if different from above)

Each participant is required to work on a Business Project throughout the year. The Business Project is intended to help you focus your learning, broaden your knowledge, and bring solutions back to your agency. The first step in this process is to identify a business problem or opportunity which should be a potential solution you are passionate about and want to research further. Articulate the problem or opportunity in 100 words or less. *

Are you interested in earning any type of continuing education credits? If so, enter the type of credits your are seeking.

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