The Leadership Circle Workship Registration


	WORKSHOPS

	Introduction
	The Authentic Leader
	Mastering Leadership
	Pathways to Partnership

	WORKSHOP CERTIFICATION
	Introduction
	Dates & Fees
	Registration

Workshop 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 . . . . $3,500.00 USD

ALL FIELDS REQUIRED

Date of Certification:


	Toledo - Sylvania, Ohio	2008-September	22, 23, 24, 25, 26	Mon-Fri

Name:

Email:

Position:

Company:

Street Address:

Street Address 2:

City:

State:

Zip:

Country:

Phone:

Fax:

Have you participated in the following programs which are prerequisites for The Leadership Circle Workshop Certification ?

The Leadership Circle Profile Certification

Yes
No

The Authentic Leader Workshop

Yes
No

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

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