Name*

First Last

Email*

Phone*

Address*

Street Address City State ZIP Code

Name of Company*

Company Address*

Street Address City State ZIP Code

Current Title*

How long have you held your current position?*

Have you been in a management position for at least 3 years?*

Yes
No

Please list your professional background.*

Please list your educational background.*

Please describe your management role and responsibilites.*

What is your biggest challenge in managing people?*

What is your interest in the program professionally?*

What is your interest in the program personally?*

In order of importance, please rate: • Self-growth •Networking •Development of Leadership Skills*

What is one of your PROFESSIONAL accomplishments of which you are most proud?*

What is one of your PERSONAL accomplishments of which you are most proud?*

What is the biggest challenge women face in Broward County today?*

Have you participated in any other Leadership Broward Foundation program?*

Yes
No

If you answer yes above, what program and class were you in?

How did you learn about Women Leading Broward?*

Please confirm that you will be able to attend the WLB Program Dates and Times below.*

Yes
No

Orientation January 8, 2024 – 4:30 p.m. – 6:30 p.m.
Session I – January 24, 2024
Session II – February 28, 2024
Session III – March 20, 2024
Session IV – April 24, 2024
Session V - May 22, 2024

MEET LEADERSHIP BROWARD CLASS XLII

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LEADERSHIP BROWARD NEWS

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Follow The Leader in You

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