Leadership Pilgrimage to Bhutan: A Journey of Personal and Professional Transformation
Thank you for your interest in the "Leadership Pilgrimage to Bhutan" September 28, 2017 to October 8, 2017. Registration and participation is only by application.
Please complete this application in its entirety. Applications must be received prior to each registration deadline in order to receive the listed pricing for each registration deadline.
Participants will be accepted on a first-come first serve basis. Applications will be reviewed as received and participants notified of a decision within one week.
Please be aware that the number of participants is limited to 18-22. We may contact you if there are questions about your application.
Primary Phone Number
Secondary Phone Number
International Phone Number (if applicable)
Address Line 1
Address LIne 2
Preferred Gender Identity
Furthest Level of Education Completed
Please select the employment status that best describes you
Occupation or Professional Title
Company or Organization
Current Role and Leadership Capacity
What is your leadership experience? In a few sentences please describe your current employment situation, as well as your role and leadership capacity within your current organization and prior organizations.
Interest in the Leadership Pilgrimage to Bhutan
In a few short paragraphs please describe your interest in the "Leadership Pilgrimage to Bhutan: A Journey of Personal and Professional Transformation." Include your experiences with previous programs; the subject matter of this program and how this program might benefit you personally and professionally?
Contributions to Community and Workplace
The individuals that participate in our program each add their unique perspective to the experience. In a brief paragraph, explain what contribution you would bring to the learning community and how you might apply the learning in your workplace or local community.
What leadership challenge or opportunity are you currently facing? How might the "Leadership Pilgrimage to Bhutan" support or alter your future approach to this challenge?
Please provide any additional information that you feel will help us make a decision.
How did you find out about the program?
ALIA Community of Practice
Email Blast: ALC
Email Blast: Other - please name person or organization below
Magazine Ad: Mindful
Magazine Ad: Lion's Roar
Magazine Ad: Buddhadharma
Magazine Ad: Tricycle
Professional Conference - please name conference below
Social Media: Facebook Ad
Social Media: ALC Facebook Post
Social Media: Naropa Facebook Post
Social Media: Shared Facebook Post
Social Media: Twitter
Website - please name website below
Word of Mouth - please name person or event below
Send me a copy of my responses
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