FEA PROGRAM APPLICATION SPRING 2023 COHORT

FEA PROGRAM APPLICATION
SPRING 2023 COHORT

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New Blended Program Delivery Model Starts in May! - Calgary

LEGAL INFORMATION

PRIVACY NOTIFICATION

COLLECTION AND USE: The personal information you provide to us during this application process is collected and used for purposes relating to the Family Enterprise Advisor (FEA) Program.

EXTERNAL STORAGE: This application process is managed using online service providers. By submitting your application, you are consenting to the collection and storage of your information on servers located in the United States.

Please check the box below to continue

I AGREE

PROGRAM SCHEDULE

IN-PERSON - May 11-12, 2023 - Business Family Dynamics - Calgary

VIRTUAL - June 8-9, 2023 - Business Boards and Family Councils

VIRTUAL - July 5, 2023 - Family Enterprise Strategy

VIRTUAL - July 12-13, 2023 (2 half days) - Facilitation and Communication Skills

IN-PERSON - October 16-18, 2023 - Multi-Disciplinary Advising - Toronto

VIRTUAL - November 13-14, 2023 - Continuity Planning

IN-PERSON - March 4-5, 2024 - Knowledge Integration and Application - Vancouver

PAYMENT OPTIONS | FEA PROGRAM

*Program fee includes tuition, all course materials (digital only), meals for in-person modules, the FEA examination fee and a one-year complimentary associate membership in Family Enterprise Canada.

*All fees are subject to applicable taxes.

One-Time Payment Option	$16,700*			Grand Total
Payment Due Date	Mar 13, 2023			$16,700*
Payment Plan Option	1^st Installment	2^nd Installment	3^rd Installment	Grand Total
Payment Due Date Installment Amount	Mar 13, 2022 $8,000*	Jul 14, 2023 $4,500*	Oct 31, 2023 $4,500*	$17,000*

Please select your preferred payment option:

One-time paymentPayment-Plan Option

Please review our FEA Program Cancellation policy prior to submitting your application.

Please check the box below to continue

I HAVE READ THE CANCELLATION POLICY

PERSONAL DETAILS

Title

First Name (e.g. Robert)

Preferred First Name (name by which you are commonly known by, if different from the above e.g. Rob)

Last Name

Gender

How did you hear about us?

Please list your referral (name of person/organization)

Please list the specific conference/event

Other details

Dietary Restrictions

PROFESSIONAL DETAILS

Current Job Title (enter unemployed if currently not working)

Organization Name (enter Independent if you do not have an organization name)

Portion of Practice Involving Families in Business

Primary Area of Practice (select one choice)

Additional Area of Practice (select one choice)

Website

E-mail

Alternate E-mail

Employer Address Line 1

Employer Address Line 2

Employer Address Line 3

Employer City

Employer Province/State

Employer Postal/Zip Code

Employer Country

Telephone (Please include extension if applicable)

Mobile Phone

BILLING INFORMATION
Please specify how you would like invoices to be made out if different from previous.

Billing Organization Name

Billing Address Line 1

Billing Address Line 2

Billing City

Billing Province/State

Billing Postal Code/Zip Code

Billing Country

E-Mail Address of Billing Contact

Telephone Number of Billing Contact (include extension if applicable)

DESIGNATIONS

Please select the number of designations you have

Designation 1

Abbreviation

Full Name of Designation

Conferment Year

Designation 2

Abbreviation

Full Name of Designation

Conferment Year

Designation 3

Abbreviation

Full Name of Designation

Conferment Year

Designation 4

Abbreviation

Full Name of Designation

Conferment Year

Designation 5

Abbreviation

Full Name of Designation

Conferment Year

ADDITIONAL TRAINING OR PROFESSIONAL CERTIFICATIONS

Please select the number of certifications you have

Certification 1

Full Name