Apply for WLP

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? *

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? *

9. Is there anything else that you would like us to know about you and your experiences as we consider this application? *

Submit