Unlock your Leadership DNA - Fire Inside Leadership

Name*

First Last

Preferred pronouns

Organization*

Position

Work Address (for invoicing purposes)*

Street Address Address Line 2 City Province Postal Code

Work Phone

Mobile Phone*

Email*

Was your Peer Leadership Program inside your organization?*

Yes
No

If you answered no above then please let us know the year you graduated the Public Program below.

Have you completed the Leadership Circle Profile™ with Fire Inside Leadership?

Yes
No

Do you wish to include the additional three one hour coaching sessions?

Yes
No

Do we have your permission to share your e-mail with your fellow Program Participants?*

Yes
No

Do you want to receive updates from Fire Inside Leadership?*

Yes
No

Food allergies we should be aware of:

The fee for the program is $4020 (net of HST). Each participant can opt to include three one-hour individual coaching sessions for an additional $900 which bring the price to $4920 (net of HST). A non refundable deposit of $500.00 plus HST is required at registration to reserve your space.

“Unlock Your Leadership DNA” Program Registration