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Participant Information
First Name
Last Name
Company Name
Title/Position
Email
Phone
Location (City,State)
Participation Details
Session Selection:
Session 1: May 21 - Foundations of Great Leadership Performance
choose one
GMA/APAN Member: $225
Non-Member: $325
Session 2: June 23 - WorkforceSUCCESS® - Recruit, Retain, Reward
choose one
GMA/APAN Member: $225
Non-Member: $325
Session 3: July 21 - Developing Leaders at Every Level
choose one
GMA/APAN Member: $225
Non-Member: $325
Session 4: October 5 - Performance Analytics for Leaders
choose one
GMA/APAN Member: $225
Non-Member: $325
Session 5: November 10 - Navigating Change & Future Leadership Models
choose one
GMA/APAN Member: $225
Non-Member: $325
Attendance Location:
choose one
In-Person
Virtual
Senior Leader Participation:
Will a senior leader attend with this participant?
choose one
Yes
No
If yes:
Senior Leader Name
Senior Leader Title
Senior Leader Email
Leadership Profile
1. What is the participant's current role within the organization?
choose one
• Owner/Executive
• Production Supervisor / Manager
• Department Lead / Team Lead
• Operations Manager
• Sales / Customer Experience Leader
• Administrative / Support Leader
• Individual Contributor (not yet supervising others)
• Other
2. How long has the participant been in a leadership or supervisory role?
choose one
• Not currently in a leadership role
• Less than 1 year
• 1–3 years
• 3–5 years
• More than 5 years
3. Which leadership challenges is the participant currently experiencing?
Delegating work effectively
Holding team members accountable
Managing performance issues
Communicating expectations clearly
Leading through change or uncertainty
Balancing operational workload with leadership responsibilities
Building confidence as a leader
Developing future leaders on the team
4. Is this participant being intentionally developed for future leadership responsibility?
choose one
• Yes – expected within 12 months
• Yes – 1–3 year development
• Possibly – exploring potential
• No formal plan
5. Which leadership skills would you most like this participant to strengthen?
(Select up to three)
Coaching and developing others
Decision-making and problem solving
Communication and influence
Performance management
Time and priority management
Leading teams under pressure
Understanding business and financial impact
Building culture and engagement
6. How does your organization currently approach developing future leaders?
choose one
• Informal / on-the-job learning
• Structured internal development
• External training programs
• Mentoring or coaching programs
• Limited focus today
7. Is there anything specific you would like us to understand about your organization, team or leadership goals?
8. What is the most important outcome you hope to achieve through this program?
- denotes required fields
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