(*) denotes required information.

* Organization Name:

* Contact Name:

* Email:

* What is your position within the organization?

* Why would you like to hold a GLC workshop for your organization?

* What type of session are you hoping the GLC can run for your organization?
Self and Team Assessments Understanding Differences Purposeful Collaboration Motivating Others Developing Long Term Goals Other

* What are your objectives for the workshop? What do you want to accomplish?

* Want do you want the participants to learn from this experience?

* Please provide some possible dates and times that your members would be able to meet.

* How long would you like this session to be?

* How many people do you expect to attend the session?

* Do you have a preferred location for the workshop?

* What is your budget for this experience?

* How involved would you like to be in the planning and implementation of this program?