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Women's Leadership
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Eligibility Requirements
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Recording Notice
Women's Leadership program Application
*
Indicates required field
1. Name
*
First
Last
Date of Birth
*
Gender
*
Male
Female
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
2. Reference Information. All references will be verified. Please upload reference letter.
*
Max file size: 20MB
3. What is your current employment situation? Please be specific.
*
4d. Tell us about your goals and/or what you hoped to accomplish in the program?
*
4a. Have you utilized the services of a non-profit career training and assistance program?
*
Yes
No
4b. Please list the name and details of the non-profit career training and assistance program.
*
4c. The length of time in the program?
*
Less than 1 month
1-6 months
1-3 years
5. How would you benefit from participating in the COSIA LBTS Women's Leadership Program?
*
6. How might COSIA benefit from your participation in the COSIA LBTS Women's Leadership Program?
*
8a. How will you travel to and from the 2016 conference?
*
8b. What is your preferred option of attendance to the 2016 Retreat & Conference?
*
August 13, 2016 (Day Setting Only)
Aug 13, 2016 - Aug. 14, 2016 (Overnight)
9. Is there anything else that you would like us to know about you and your experiences as we consider this application?
*
Submit