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Graduate Program Registration

Graduate Program Registration

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Program*
- Regional Gathering - Cincinnati - Nov. 30-Dec. 2
- Regional Gathering - Scottsdale - Feb. 15-17
- Regional Gathering - St. Louis - Mar. 22-24
Please specify which program(s) you would like to register.
Phone*
Cellphone Preferred
Leadership Development Program Attended*
- CLDP
- WRLL
- CSC
- Leaders as Leaven
- MLDP
- IHM
Please indicate which leadership development program you have participated in previously.
CLDP Cohort
If you attended a CLDP, please indicate which cohort.
Do you need to complete the StrengthsFinder tool in order to prepare for the gathering?*
- Yes
- No
Participants are required to have completed the StrengthsFinder tool and provide their Top 5 Strengths prior to the gathering. If not previously completed, the LC will make arrangements for completion.
If you have already completed the StrengthsFinder, please list your Top 5 Strengths here in order.
Do you need to complete the Leadership Circle 360 tool in preparation for the gathering?*
- Yes
- No
Participants are required to have completed TLC 360 and debrief prior to the gathering. If not previously completed, the LC will make arrangements for completion.
Do you have any mobility issues or other physical needs we need to be aware of?
- Yes
- No
Mobility Accommodations
Do you have any special food needs?
Other Food Accommodations
Please note allergies or indicate other needs below:
Do you have need for a translator?
- Yes
- No
Translator Needed
Please indicate language below.

Additional Information Coming Soon!

Nancy Murphy

When I was asked by my community to attend...

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Leadership Collaborative

8380 Colesville Rd, Suite 300
Silver Spring, MD 20910

Call us: 301-587-0423
Email us: rwaters@sistersofmercy.org

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