Application Form – Leading and Influencing Change in CPD

Please complete the following application form to be considered for the 2024-2025 Advanced CPD Leadership Development digital program. Applications will be reviewed by the Program Directors and you will be advised of their decision within two weeks. A registration link with instructions will be sent upon review and acceptance of your application.

"*" indicates required fields

Name*

First Last

Credentials

Position

Organization/Company

Department

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Office Phone

Mobile

Please provide a brief description of your current position and responsibilities within Continuing Professional Development*

Number of years working in CPD:*

What background or relevant training do you already have in adult education, continuing education, faculty or organizational development?*

What do you hope to achieve by participating in the Leading and Influencing Change in CPD program?*

Biography*

Drop files here or

Max. file size: 188 MB.

Abbreviated CV/Resume*

Drop files here or

Max. file size: 188 MB.

(Limit: 2 pages, past 5 years’ experience)

I have uploaded a current CV/Resume with this application

I have uploaded a current brief biography with this application