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* 1. My name is...

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* 2. Email Address:

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* 3. A little about why I want to join an Amazing Women Leaders (AWL) cohort...

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* 4. The one thing I'd really like to be different for me as a result of AWL is...

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* 5. Please indicate that you are happy to make the following commitments by ticking the appropriate boxes.

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I fully intend to attend all six facilitated sessions.
I am committed to doing the work (some thinking, some actions) in and between sessions to see results.
I am committed to supporting, challenging and championing my fellow AWLs.

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* 6. I identify as...

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* 7. I am aged...

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* 8. All sessions will be held face-to-face on a weekday, once every 4-6 weeks in central London, starting in November.
I am able to attend sessions... (please tick all that apply)

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* 9. I heard about the AWL programme via

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* 10. I intend to...

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