Name *

First Name

Last Name

Role In Purchasing Process *

Decision Maker

Evaluator / Recommender

Influencer

Not Involved

Phone number (for reminders) *

(###)

###

####

Number of Employees *

1-25

26-50

51-100

101-300

301-500

500-1500

1501-3000

3000-5000

5001-10,000

Over 10,000

Are you currently employed as an Executive? *

Yes

No

Are you self-employed as an independent Consultant?

Yes

No

Thank you. Please expect an invite from leila@leadershipimpactstrategies.com

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