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CLC Application Form
Please fill out the application form below to be considered for either our Northern or Southern California CLC program. We have certain business criteria we'd like our members to meet, however we will review each application individually. Feel free to contact us with any questions. Once received, we will be contacting you about next steps. Thank you for your interest!
Name
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First
Last
Current Role/Title
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Gender
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Male
Female
Company Name
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Website URL
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Phone
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Email
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Preferred Meeting Location
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SoCal – San Clemente
NorCal – Bay Area
Please select the meeting location you'd like to attend CLC workshops at.
Birthdate
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MM slash DD slash YYYY
Company Location(s)
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Number of Offices
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Number of Full-Time Employees
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Last Fiscal Year's Sales Revenue in Millions (USD)
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Please check the following boxes that apply:
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I manage a budget of > $1,000,000
I manage a budget of < $1,000,000
I make purchasing decisions
I do not manage a budget
I manage >5 employees
I manage <5 employees
I do not manage employees
How did you hear about CLC?
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Newsletter
Colleague
Family Member
Social Media
Google/Online Search
Productive Learning Employee
Other
Current Business and/or Personal Leadership Objectives
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Have you attended a Productive Learning Workshop before?
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Yes
No
If you have attended a Productive Learning Workshop before, please list the workshop dates and titles below:
(Year of workshop is fine)
Is there anything else you'd like us to know about your application?
*