Confidential Enrollment Form

Thank you for your request to participate in Communication for Leadership and Results!

There are currently no scheduled programs at this time.

However, you may fill out the form and an agent will contact you when a program becomes available.

Personal Information
First Name
Last Name
Name you like to be called

Work Information

Title
Company
Work Address
  • Street
  • City
  • State
  • Zip or Postal Code
  • Country
Work Telephone
Cell Phone
Fax Number
E-Mail Address
Assistant's Name and Phone

Home Address (in case of emergency only)
  • Street
  • City
  • State
  • Zip or Postal Code
  • Country
Home Telephone
Home E-Mail Address

Job Information

How long have you been in your current role?
Brief job description

Project Idea

As you know, Communication for Leadership and Results is a results-oriented workshop in which you learn and apply powerful communication practices to your current business projects in an action-learning model. To help you enhance your ability to produce extraordinary business results and put what you learn into practice, please describe the business project that you want to work on in the course. Please include specific, measurable results that you are committed to delivering. These results should be beyond what you can currently see is possible to provide, and will be a demonstration that you have increased your ability to provide leadership through communication. If you don't have a project chosen just yet, you can discuss that with one of our coaches during your pre-course coaching call. You can send in the registration without having a project chosen.

Project:
Results (please include a date by when you will produce these results):

Payment options

We accept checks (personal or corporate) and Visa, MasterCard and American Express. If you prefer to pay by credit card, you will be able to provide your credit card number to us with the invoice.

Checks can be mailed to:
Program Management
Generative Leadership Group
92 E. Main Street, Suite 205
Somerville, NJ 08876

When you hit "submit", your completed application will be forwarded to our offices. You will receive an e-mail confirmation that your application was received, and an invoice will be sent to you by e-mail.

Thank you for your interest in Communication for Leadership and Results! We are looking forward to working with you at your course! 

The program has been developed by and is owned by Generative Leadership Group.  The contents of the program, along with the design and structure of the program itself, are proprietary to and have been kept confidential by Generative Leadership Group.

As part of the consideration for your participation in the program, you agree to maintain the confidentiality of the program, its content, design and structure.  This does not mean that you cannot use what you learn from the program or talk to others about it, but rather that you agree not to, either during the course of the program or at any time thereafter:

  • Repeat in detail the conversations that comprise the program. 
  • Copy, duplicate or permit the copying, duplication or distribution of all or any part of the materials provided to you during the program.
  • Publish, disclose, resell or in any other manner reveal or use, either directly for your own benefit or the benefit of someone else, all or any part of the content, design or structure of the program or any of the materials provided to you during the program.

By submitting your application for the program,  you agree that you have read and understand its terms, and agree to be bound by them.

Generative Leadership Group | 92 E. Main Street, Suite 205 | Somerville, NJ 08876 | Tel 908.722.5100 | 800.752.6912