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GLOBAL WOMEN ON BOARDS

PRE-APPROVAL AND REGISTRATION FORM


Thank you for your interest in the Global Women On Boards Programme. We would appreciate if you could complete this pre-approval and registration form for acceptance review.


1 | PERSONAL DETAILS

Name :
Email :
Mobile:
-
Age:
Education:

2 | CURRENT OCCUPATION:

Company:
Designation :
Year Begun:
No. of Staff reporting to you :


Immediate Superior (if applicable)

Your Superior's Name:
Your Superior's Title:


His/Her Immediate Superior (if applicable)

His or Her Designation :

3 | EXECUTIVE HISTORY (last held executive position)

Previous Company:
Last Held Position:
Year Start:
Year Ended:

4 | PROFIT & LOSS EXPERIENCE

Do you have P&L experience?
If Yes, please indicate:

5 | FUNCTIONAL COMPETENCIES/SKILLS 

List maximum up to 5:

6 | YOUR INDUSTRY EXPERTISE

List A maximum of up to 3 :

7 | BOARD EXPERIENCE

Are you currently sitting on any boards (public, private or non-profit)?
If Yes, please provide company name(s), your role and date appointed:

8 | BOARD PREFERENCE

If you aspire to serve on board, what are your industry preference:
Board outside Malaysia :
Board Type :

9 | PLEASE STATE YOUR PURPOSE FOR SIGNING UP THIS PROGRAMME.

Purpose:



REGISTRATION FORM

(Subject to Acceptance by Admission Committee)


Please register me for:

BILLING PARTICULARS


Contact Person :
Position :
Billing Company :
Mailing Address :
B_Tel:
B_Email :
Postcode :

FOR YOUR INFORMATION

Programme Fee (remitted in advance) includes refreshment, lunch, course materials  

Programme Fee/Venue:

Global Women on Boards KENYA Module - Building the Foundation: 22-26 April 2019 : USD2,750 per pax | Nairobi, Kenya

Global Women on Boards MALAYSIA Module - Preparing for Board Roles: 4-8 November 2019 : USD2,750 per pax | Kuala Lumpur, Malaysia

To Register:

Please complete this form and email to:  marcella@lead-women.com and  info@womenonboardskenya.co.ke

Terms & Conditions:

Application
  • Upon submission, your application will be reviewed by the GWOB Committee.
  • The decision of the GWOB Committee will be communicated to you via email.

Cancellation & Refund

  • Non-attendance does not constitute cancellation.  You can propose a substitute for the programme, however, the substitute participant will need to submit an application and gain approval by the GWOB Committee to attend. 
  • Substitution/Cancellation must be received in writing to marcella@lead-women.com  4 weeks before the event.
  • Administration fee of 20% will be charged for cancellation.
  • Cancellations less than 4 weeks before the event will not be refunded.
  • No shows will result in full forfeiture of the fee you made to the programme.

For Government Officials:

  • A local Order (LO) or Letter of Approval to participate must be sent before the event.

Disclaimer:

  • The Organiser reserves the right to change the date(s), Speaker(s), and venue and to cancel the programme due to  circumstances beyond the Organizer's control.