First name*

Last name*

Email*

School*

Job title*

City*

State/Region*

What most engages you about the HLA Manifesto and the HLA Black Belt Program?*

What are you currently doing to expand Humanistic Leadership?*

When did you complete and graduate the HLA Professor Cohort Program? What was your biggest takeaway?*

I commit to participate in all areas in the Program Overview and will show up with my full presence to contribute to the conversation and support fellow participants.*

(Optional) Your Bio (.pdf, .docx, .txt)

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