The Leadership Circle 360 Feedback Profile Registration


	TLC PROFILE

	Introduction
	Benefits / Advantages
	Brochure
	Results Graphic
	Whole Picture
	Creative Competencies
	Reactive Assumptions
	Summary Dimensions
	Research

	PROFILE CERTIFICATION

Australia Profile Certification Registration

Please fill out this on-line registration form and complete all questions. After you submit your registration, you will receive phone or e-mail acceptance into the certification program. Payment in full is then required in order to reserve your seat. You will be invoiced. Payment can be made by cheque, EFT, Visa, or MasterCard (incurs a 2.5% processing fee). We will also send you hotel reservation information and travel directions via e-mail.

Registration Fee . . . . AU$ 3,500.00 plus gst
Early Bird Fee . . . . . . . .20% discount when pay in full by 14 July

ALL FIELDS REQUIRED

Date of Certification

Select a Date

Sydney - New South Wales

2010-November

10, 11, 12

Wed-Fri

Contact Information

Name:

Email:

Position:

Company:

Street Address:

Street Address 2:

City/Town:

State or

Province / Territory:

Zip / Postal Code:

Country:

Office Phone:

Cell Phone:

Fax:

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

Yes
No

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:

Please enter ONE name.
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

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

For information call +61 2 8001 6570
or e-mail your questions to info@theleadershipcircle.com.au

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