ProInspire Leadership Institute (PLI) Workshop Registration 2022
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Registration is open for November. Stay tuned for 2023 dates.
Thank you for registering for PLI: Managing People and Power! We look forward to co-creating space with you.
First Name
Last Name
Primary Mailing Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Address Type
Please select...
Home
Work
Other
Preferred email
Personal
Work
Other
Work Email
Personal Email
Other Email
Preferred phone
Mobile
Work
Home
Work Phone
Mobile Phone
Home Phone
Age
Please select...
18-24
25-34
35-44
45-54
55-64
65+
I prefer not to answer
Gender
Please select...
Female
Male
Trans Male
Trans Female
Gender Variant/Non-Binary/Non-Conforming
Not Listed (please specify)
I prefer not to share my gender identity
Gender (other)
Race/ethnicity
Please select...
American Indian or Alaskan Native
Arab, Middle Eastern, or North African
Asian or Asian American
Black or African American
Latinx or Hispanic
Multi-racial or Multi-ethnic
Native Hawaiian or Pacific Islander
White or Caucasian
I prefer not to share my racial/ethnic identity.
Not Listed (please specify)
Race/ethnicity (other)
Please select which program you are registering for:
Please select...
November 2-4, 2022
Accommodations
If you require accommodations to participate in the three full-day workshops, please list them below (e.g., closed captioning)
We will take group photos during workshops and may use them on social media, our website, or in marketing materials. Do you agree to be included in these images?
Yes
No
Your Work and Experience
Current Employer
Current Job Title
How many years have you been in this role?
Please select...
<1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
>20
Total years of full-time work experience as of today
Please select...
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
>20
What types of responsibilities do you have in your role? (Select all that apply.)
Manage budgets
Manage direct reports
Manage funders
Manage projects
Manage stakeholders
Manage teams
N/A
Have you received any leadership or managerial training since becoming a manager?
Yes
No
Does your employer primarily support any of the following communities through its work? (Select all that apply.)
racial and ethnic minorities
women
refugees
incarcerated and formerly incarcerated individuals
unhoused and formerly unhoused people
veterans
people with disabilities
members of the LGBTQIA+ community
Your Supervisor's Information
Supervisor's First Name
Supervisor's Last Name
Supervisor's Email
Your Background
The information you provide below will be shared with other cohort members.
LinkedIn Profile Link
Please upload a current headshot
If a testimonial is provided this headshot will be included and posted on the ProInspire website.
Use the naming convention: LASTNAMEFIRSTINITIAL.JPG.
Your Payment
Are you able to commit to fully participating in each of the three days and completing all program pre-work?
Yes
No
How large is the organization you work for?
My organization has an annual budget over $5 million
My organization has an annual budget of $2.5 - $5 million
My organization has an annual budget less than $2.5 million
Are you an alumni of a ProInspire Program, a scholarship recipient, a group participant, or do you have a PLI Discount Code?
Please select...
An Alum of a ProInspire Program
A ProInspire Scholarship Recipient
A Group Participant
PLI Discount Code
None of the Above
Alumni Discount Code
Scholarship Recipient Code
Group Discount Code
PLI Discount Code
Total
Including discount, if applicable.
Payment Information
Name on Card
Card Number
MM
YY
Code
Please enter the email address where your registration confirmation should be sent
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ProInspire Leadership Institute terms and conditions
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