Application for Leadership For Real Impact

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This is the application form for the Leadership For Real Impact - a leadership course for mission-driven leaders to cut through resistance and transform business as usual.

If you work on climate action or social change, whether your work title reflects it or not, this course is for you. We look forward to meet this extraordinary cohort of leaders!

More details about the program can be found here:

https://www.ourcoevolution.com/realimpact

We will quickly process your application and follow up with a welcome email and request a method of payment. The course includes six 2-hour sessions on Friday mornings 9 am Pacific Time, March 24, 31, April 7, 21, 28, and May 5. A 1:1 coaching session is included for each participant. Enrollment will be capped at 12 participants.

Pricing - EARLY BIRD $995 by March 6; Standard - $1,195 after March 6

First and Last Name *

Preferred Pronouns *

She/her/hers

He/him/his

They/them

Other:

Required

Company or Organization (if applicable)

Mobile Phone *

Do we have your permission to share your contact information with the rest of the group?

Yes

Clear selection

Please share something about your climate change and/or social impact work and aspirations. *

What brings you to this program? *

Investment Levels *

EARLY BIRD - $995

Standard after March 6 - $1,195

A self-selected reduced fee of US $395 for participants who belong to historically underrepresented groups - e.g. people of color, indigenous people, people with disabilities.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms