Linkage, Inc. - Application for the Advanced Practitioner Track

Application for the Advanced Practitioner's Think Tank

Thank you for your interest in the 2008 Organizational Development Summit and for your interest in the Advanced Practitioner Think Tank. Please complete this form in its entirety to be considered for participation. To ensure that the group gets the most from the session, attendance will be limited, and admission to the Advanced Practitioners' Think Tank will be on a first-come, first-served basis. The target participants in this track are senior-level practitioners who assume leadership responsibility for OD initiatives within their organization from public or privately owned companies, from select nonprofit and government organizations; as well as senior, highly experienced external OD Consultants. Please use as much space as necessary to answer the following questions.
Fields followed by an asterisk (*) are required information.

Personal Information

*First Name:

*Last Name:

*Title:

*Address 1:

Address 2:

*City:

*State/Province:

*Postal Code:

Country:

*Phone:

Fax:

*Email:

*How many years work experience do you have?

*How many years have you been working in the field of Organizational Development?

*How many years have you been in your current position?

*What are your principal OD responsibilities?

*What is your educational background?

*What are the primary reasons for your attendance at the 2007 OD Summit?

*Are you an OD Summit alumnus/a?