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Black Achievers: Women's Academy Application
Complete this form for the Black Achievers virtual education program!
Please reach out to
michael.moore@blackachievers.com
with any questions.
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* Indicates required question
Email
*
Your email
What is your full name?
*
Your answer
What is your cell phone number?
*
Your answer
What is your Linkedin profile link? (Put N/A if you don't have one)
*
Your answer
What city and state are you currently located?
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Your answer
Where do you currently work?
*
Your answer
What is your work background? Industry, how long have you been in your field etc.
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Your answer
What do you hope to gain from your participation in our Leadership Academy?
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Your answer
Check all areas you interested in learning more about:
Leadership Skills
How to Get Promoted at Work
Finding a Mentor
Finding Sponsors at Work
Negotiating Hire Paying Salary
How to Deal With Micro-Agressions at Work
Other:
PARTICIPATION & COMMITMENT
I Agree that I will attend at least half of all program meetings:
*
Yes
Thank you for taking the time to share your information with us ! We look forward to discussing your application with our selection committee. You will be notified if you have been selected.
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