Women Directors Leadership Programme Application Form

PART B: CURRENT POSITIONS
Please detail your current responsibilities. If multiple, please indicate on point 1, the organisation to which you devote most of your time and use 2 detail the other one.
ORGANISATION 1
Name of Organization
Current Title
Address
City
Postal Address
Country
Phone*
Mobile Phone
Fax (Office)
Email (Office)*
This field is hidden when viewing the form
Company Web Address
Company Web Address
Main Field of Activity*
Annual Sales*
No. of Employees*
Asset(s) under your management*
Sales Managed
To whom you report*
No. of People Managed*
ORGANISATION 2
Name of Organisation
Current Title
Address
City
Postal Code
Country
Phone
Mobile Phone
Fax (Office)
Email (Office)
Company Web Address
Main field of activity
Annual sales
Number of employees
Asset(s) under your management
Sales managed
To whom you report
No. of people managed

PART D: BILLING DETAILS
Payment is due upon notification of admission and indicate the details that should appear on the invoice for this application. To enable us process your application, it is important that you complete all the following information. Please make your payments to Strathmore Business School.
Name of participant*
Invoice to*
Person in charge of invoicing (if different form above)*
Billing address*
City*
Town*
Postal code*
Country*
Phone*
Mobile Phone*
Date*
Company Website Address
This field is hidden when viewing the form
Company Web Address
Cancellation Policy
All cancellations must be made in writing. Cancellations made less than a month to the programme date are subject to a penalty of 25% of total programme fee
Date*

PART A: PERSONAL INFORMATION PLEASE COMPLETE IN BLOCK CAPITALS