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ALW OVERVIEW

PROGRAM CONTENT & SCHEDULE

ABOUT OUR FACILITATORS

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FAQ

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Electronic Form

*Name:
*Title:
*Company:
*Company Address:
*City: *State: *Zip:
*Phone (Work): ( ) -
*Home Address:
*City: *State: *Zip:
*Phone (Home): ( ) -
Phone (Cell): ( ) -
*Email: Work Home
*Emergency Contact:
*Emergency Contact Number:
   
What is your Birthdate? / / (MM/DD/YYYY)

Registration will be limited to 24 women who are seeking to strengthen themselves as current and future leaders in business and community. 8 seats will be reserved for corporate, entrepeneur, and not-for-profit.
 
If the program is full, do you want to be put on a waiting list? Yes No
 
Tuition: $975
Some scholarship monies are available for not-for-profit or small business owners/entrepreneurs.
 
Do you wish to apply for a scholarship to be applied toward your tuition? Yes No
 
Is a purchase order (P.O.) required by your company?  Yes No
 
How did you hear about our program?
 
Do you have any special medical or religious dietary restrictions?
 
Do you have any physical handicaps that will need accommodation?
 
Do you want to connect with others from your area to carpool from:
Syracuse Utica Albany Rochester Buffalo Carpool Not Needed
 
Will you need transportation from the Syracuse Airport to Stella Maris? Yes No
 
Have you completely read the FAQ section of the website? Yes No
 
I understand that this submission will reserve my spot for 5 days only, until a minimum deposit of $250 is received by Pathfinders. I also understand that all tuition monies must be paid in full for my seat to be guaranteed.
Yes
 
Print this page for your records: Please take a moment now to print this page out before you hit register to have for your records. Thanks!
 
We look forward to having you in our Authentic Leadership for Women Program!

 

Authentic Leadership for Women
a program of Pathfinders CTS, Inc.

For more information call 1(800) 439-7608, ext. 101