First Name

Last Name

Title

Email Address

Organization

Phone Number

Meals will be provided, please indicate any dietary preferences
(vegan, lactose-free, etc.)

Do you have any accessibility requirements you would like us to be aware of?

Is this your first year attending the Executive Learning Institute?

Yes, this is my first yearNo, I am returning for my second year of the ELI experience

Does your organization currently have an Engagement Package with Social Current and/or is COA-Accredited?

Yes, my organization has an Engagement Package and/or is COA-AccreditedNo / I don't know

Your Registration Fee