The Leadership Circle Profile Registration


	TLC PROFILE

	Introduction
	Results Graphic
	Whole Picture
	Creative Competencies
	Reactive Tendencies
	Summary Dimensions
	Benefits
	Research

	PROFILE CERTIFICATION
	Introduction
	Dates and Fees
	Registration

Profile Certification Registration

Please fill out this on-line registration form and complete all questions. We will confirm receipt of your registration and send you hotel reservation information and travel directions via e-mail. After your registration is received you will be invoiced for payment. Thank you.

Registration Fee . . . . $1,500.00

Early Registration . . . $1,350.00
Discount is for full certification payment received 30 days prior to the training date.

ALL FIELDS REQUIRED

Date of Certification

Ohio
	September 14, 15, 16 - 2005 (Wed-Fri) November 2, 3, 4 - 2005 (Wed-Fri)	registration is full
Washington
	October 3, 4, 5 - 2005 (Mon-Wed)

Contact Information

Name:

Email:

Position:

Company:

Street Address:

Street Address 2:

City:

State:

Zip:

Country:

Phone:

Fax:

Indicate your profession:

Please check all that apply
Coaching
Independent Consulting
Internal OD/HR/OE
Therapy
Other

How did you hear about The Leadership Circle?

Please check all that apply
Referred by a colleague
Referred by a TLC Coach/Consultant
I answered questions for a colleague's Profile
I have had a Profile done on myself
Internet search
TLC Brochure
TLC Direct Mail
Attended a TLCP presentation

Have you previously completed TLC Profile within 12 months of training date?

Yes
No

Comments:

Privacy Policy:
The information you provide will not be shared or sold to other companies.

You can also e-mail your questions to The Leadership Circle
or call us at (303) 545-5258 or (303) 877-9148