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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 Designation:


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:


10 | HOW DID YOU HEAR ABOUT THIS PROGRAMME?


Source:



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: 13-17 April 2020 : USD2,750 per pax | Nairobi, Kenya

Global Women on Boards MALAYSIA Module - Preparing for Board Roles: 2-6 November 2020 : USD2,750 per pax | Kuala Lumpur, Malaysia


To Register:

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


Admission Criteria:

Admission to the Programme is limited to individuals with specific business or board experience. All applicants will be subject to review and approval from the Admission Committee.


Terms & Conditions:

Payment

  • Full payment must be made no later than event date.
  • Cheques/Bank Draft should be made payable to LeadWomen Sdn Bhd
  • Direct Bank-in: CIMB Bank Account No. 8002618727, Swift Code CIBBMYKL.
  • Please email payment advice to traininh@lead-women.com

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 Dr Marcella at 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.