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Program Application Form
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* Indicates required question
Email
*
Your email
Which NAAAP Chapter are you from or closest to you?
*
Choose
NAAAP Boston
NAAAP New York
NAAAP Toronto
Not Applicable
First Name and Last Name
*
Your answer
Home City
*
Your answer
Email
*
Your answer
Mobile Contact Number
*
Your answer
Are you currently an active NAAAP Member?
*
Choose
Yes
No
Unsure
Year of Birth
*
Your answer
Occupation and Title
*
Your answer
Education (highest degree and concentration)
*
Your answer
Years of Work Experience
*
less than 3 years. Unfortunately, for all participants, we do require minimum 3 years' work experience.
3 to 6
7 to 10
more than 10 years
Other:
Career stages that best describes you (select all that apply)
*
Leading Self: First job, individual contributor
Leading Others: People leader, manager
Leading Enterprise: Own business function
Transition: New job
Career Change or Transition
Other:
Required
Skills that you would like to learn or improve (select all that appy)
*
Strategic communications
Executive presence
Public speaking
Ability to manage up, down and across
Networking and effective relationship building
Inclusive leadership
Navigating difficult conversations and asking for feedback
Emotional intelligence
Better work life integration
Mental health and wellness
Other:
Required
Your current situation
*
Please describe your current personal and professional situation (please highlight any specific challenges or opportunities that you face as well)
Your answer
Your Goals 1
*
What do you hope you can gain from the NAAAP Mastermind Program?
Your answer
Your Goals 2
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What are your short term and long term goals ( Describe both personal and professional areas)
Your answer
Preferred date for Mastermind sessions with a start time of 7pm EST (Check all that apply)
*
Tuesday
Wednesday
Thursday
I'm flexible for any of the weekdays above
Required
How did you hear about the NAAAP MasterMind Program
*
A NAAAP Website
A NAAAP newsletter
Through a friend or colleague
NAAAP event
Google search
Social media
Other:
Required
Send me a copy of my responses.
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