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LEAP
327 E. 2nd Street,
Suite # 226
Los Angeles, CA 90012
Phone: (213) 485-1422
FAX: (213) 485-0050
Email: leap@leap.org





2014 Path to Professional Success Program

Hosted by Georgia Power, Atlanta, GA
April 29 - May 1, 2014

Please complete this registration form. You will enter your payment information on the next page if paying by credit card.

(If you already registered, paid a deposit and are returning to pay your balance, click HERE)

*To ensure that participants receive the full benefit of the program, LEAP REQUIRES ATTENDANCE AT ALL CLASS SESSIONS, MEALS, AND STUDY GROUP MEETINGS in order to receive the certificate of completion. 

* indicates a required field

Salutation
*
First name
*
Last name
*
Name (or nickname) for name badge
*
Name as you want on certificate
*
Job title
*
Do you Manage Staff?
Yes No
Branch or Division
*
Corporation
*
Work address
*
Mailcode/Station
City
*
State
*
Zip
*
Phone (work)
* 888-888-8888
Fax (work)
* 888-888-8888
Email (work)
*
Home address
*
City
*
State
*
Zip
*
Phone (home)
* 888-888-8888
Fax (home)
* 888-888-8888
Email (home)
*
Please send mail to:
*
Emergency Contact Name
Emergency Contact Phone #
* 888-888-8888
Relationship to You
Ethnic Heritage
Generation
* How did you hear about this event? LEAP Mailing/Brochure
Friend/Family
Supervisor
Website
Colleague
Other
If other, please list

Dietary Restrictions:

Enrollment
Please enroll me for*

April 29 - May 1, 2014 Atlanta, GA
*Lodging is not included in the tuition fee. 

Tuition and Fees
Program Reservation Fee: $100 (this non-refundable fee is applied towards the full tuition)
Tuition: $2,000 (includes instruction materials and meals)

Payment type: (pick one)
How will you pay?

Check
Credit Card
Invoice

Finance charges: If you choose to be invoiced for this program, please note that the following finance charges apply if payment is not received prior to the first day of the program.  Outstanding balances after the first day of the program:
*30 days – 2% finance charge
*60 days – 3% finance charge
*90 days – 5% finance charge

REGISTRATION AND CANCELLATION POLICY
Space is reserved with a $100 non-refundable, administration fee per participant (included in the full tuition), which must accompany completed registration form to guarantee space.  All cancellations or transfers will be subject to the following policy as well as any additional charges related to materials or lodging for each program participant. 

Transfers:

  • Transfer to another session may be made up to one week prior to the program start date and will be subject to a $100 transfer fee.
  • Transfer requests made within one week of program start date will incur a charge of 10% of the full program fee.
  • Transferees will be required to pay fee increases, should any take place.

Substitutions:

  • Substitution of registrants in a session can be made for participants to attend on your original program date.
  • Substitutions cannot be made within one week of the program date.

Cancellations & Refunds:

  • There will be no full refunds for cancellations made less than four weeks prior to the program start date.
  • Participants who cancel within four weeks of the program start date will incur a charge of 25% of the full program fee.
  • Cancellations made within one week of the program start date will incur a charge of 75% of the full program fee.
  • No-shows are liable for the full tuition.

Upon submitting my registration, it is understood that any photos or videotapes of me may be use in future marketing publications.  I have read your Registration & Cancellation Policy and accept its terms

Thank you for your registration! Please click on the "submit" button below to complete the process.

 


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