Your First Name* (required)

Your Last Name* (required)

Your Email* (required)

Mobile or Office Phone* (required)

City, State where you work* (required)

Company or Organization Name* (required)

Your Role or Title

Will you be paying the masterclass fee ($875) or shall we invoice your employer?
I will be payingMy employer will be payingApply for scholarship

If your employer is paying, please include below their Name and Email address for an electronic invoice to be sent:
Employer Name
Employer Email

How did you hear about the DEI Men's Masterclass?* (required)

Please describe the reasons for your interest in the Masterclass (check all that apply): * (required)
Personal Improvement/LearningProfessional Improvement/LearningWant to be more engaged and less likely to misstepMy company has a DEI strategy and employee engagement planMy company is just beginning its DEI Journey. We do NOT have a comprehensive strategy or plan yet.Others

Sessions for the Masterclass run every other Thursday, 12:30PM to 2:30PM Eastern Time, August 31 - November 9. Will you be able to attend all of the 6 sessions on these dates? *(required)
YesProbablyDefinitely not

Thank you for submitting your application message. A member of our team will reach out to you soon!