Application for RLA APAC & North Asia 2019

Please allow 15-20 minutes to complete this application. This application form is open to member leaders from chapters within the APAC and North Asia region. A select number of seats are reserved for member leaders from outside APAC & North Asia.

Last Name *
First Name *
EO Chapter *
Email *
Please confirm that you have served in one of the following roles:

1. Chapter Board Member
2. Regional Council Member
3. Global Committee Member
4. Expert *
Yes, I have served or currently serve in one of the above roles
• The Regional Leadership Academy content is presented entirely in English. Please confirm that you are fine with it. (translation might be provided) *
Yes, I am fine with it.
• Please verify that you understand the following information:

-The program runs from 13 September – 17 September 2019. If you are accepted, there is a requirement to participate for the entire program from 6am-11pm daily, no exceptions.

-If you are accepted, the program fee is $1800 USD which includes registration fees, and meals during the program but does not include travel, airport transfers, hotel accommodation and incidental expenses.

-If you are accepted, you are required to stay in the designated program hotel(s) for the duration of the event, no exceptions.
*
I understand all the requirements and information above.

Year Joined EO *

EO Resume
-Please list any leadership roles you have held in EO
-Begin with the most recent/current position and list one role on each line
-i.e. 2016/17: Forum Chair (EO Malaysia) *

List and describe three (3) EO Leadership accomplishments that you are most proud of. (250 words max) *

What would you consider your most significant EO leadership failure? (250 words max) *

What does "leading in diversity" mean to you? How is this term relevant to leadership in EO? (250 words max) *