The Leadership Circle 360 Feedback Tool Registration


	TLC PROFILE

	Introduction
	Benefits / Advantages
	Brochure
	Results Graphic
	Whole Picture
	Creative Competencies
	Reactive Tendencies
	Summary Dimensions
	Research

	PROFILE CERTIFICATION

Profile Certification Registration

Please fill out this on-line registration form and complete all questions. After you submit your registration, you will receive phone or e-mail acceptance into the certification program. Payment in full is then required in order to reserve your seat. You will be invoiced. Payment can be made by check, Visa, or MasterCard. We will also send you hotel reservation information and travel directions via e-mail.

Registration Fee . . . . $2,495.00

ALL FIELDS REQUIRED

Date of Certification

Select a Date

Washington, DC - Gaithersburg, MD	2008-September	8, 9, 10	Mon-Wed
Toledo - Sylvania, Ohio	2008-November	5, 6, 7	Wed-Fri
San Diego, California	2008-December	3, 4, 5	Wed-Fri

Contact Information

Name:

Email:

Position:

Company:

Street Address:

Street Address 2:

City:

State:

Zip:

Country:

Phone:

Fax:

Have you previously completed TLC Profile within 12 months of training date?

Yes
No

Indicate your profession:

Please check all that apply
Coaching
Independent Consulting
Internal OD/HR/OE
Therapy
Other

How did you hear about The Leadership Circle?

Please check all that apply

Referred by:

Please enter ONE name.
I answered questions for a colleague's Profile
I have had a Profile done on myself
Internet search
TLC Brochure
TLC Direct Mail
Attended a TLCP presentation

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You can also e-mail your questions to The Leadership Circle
or call us toll free at (800) 895-0399