Leadership Alliance™

Executive Development Program
for Women on Their Way to the Top

  Personal Data:

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Executive Sponsor

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Programs: *

Please sign me up for the following year-long program:

Leadership Alliance • $7,500 USD/year • Starting Fall 2006, in Southern California

Including:
6 one-day sessions (every other month for one year)
360-degree assessment and feedback with individual coaching from group leaders
Conference call each month with personal “Board of Directors.”

  Payment Method: *

Check enclosed Please issue invoice

Please make checks payable to
Executive Women’s Alliance
Tax ID# 72-1591275

Credit Card: Visa Mastercard American Express

Card number
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CANCELLATION POLICY
No refunds will be given for cancellations one month prior to program start date. Cancellations received before this date will receive a full refund less 20% processing fee. Substitutions may be allowed with authorization from Dr. Carol Gallagher.

*Required Fields

Submit registration form by clicking above, or print and send to:
Executive Women's Alliance • 14020 Broadway Terrace • Oakland, CA 94611
Fax: 510-899-8204 • Phone: 510-899-8202 • info@executivewomensalliance.com

Once received, your registration will be confirmed and session materials will be sent to you.

Leadership Alliance™

Executive Development Program for Women on Their Way to the Top

Executive Development Program
for Women on Their Way to the Top