Impact Executive Leadership Program Application

Which cohort are you applying to?*

First name*

Last name*

Name pronunciation

Not required, but feel free to share how to properly pronounce your name.

Email*

Phone number*

Employer*

Job title*

LinkedIn Profile*

How did you learn about the Impact Executive Leadership Program?

A past participant of an Impact Center Executive Leadership Program recommended it to me.

My supervisor recommended it to me.

I was actively looking for professional development programs and found it via online search.

I saw it on social media.

I received an email from The Impact Center.

I saw an online ad.

Other.

Please respond to the following questions in a separate document. Please do not exceed two pages total as you answer these questions.

Please describe your career trajectory in a few sentences - where are you now, how did you get to your current position, and where do you want to go?
If we asked your peers, what do you think they’d say about your reputation as a leader or your leadership style?
Why do you want to participate in the Impact Executive Leadership Program? What do you think are your most important opportunities for growth as a leader or what challenges do you want to address through the Program?

Please attach a PDF of your responses (2 pages maximum) to the questions above.*