The Heart of Leadership

•Registration•

To register, please fill out this form and send it along with a $200 non refundable registration fee or full tuition ($1595) to the address below, fax it to the number below, or e-mail it to us as an attachment at <amba@galeleadership.com> and put the deposit in the mail, made payable to Gale Leadership Development, LLC. The tuition is due in full on September 22, 2010.

October 13, 14, 15 and November 4, 5, 2010

Your Name _____________________________	On Your Nametag __________________
Today's Date ____________________________
Company __________________________
Business Address Street __________________________________ City/State/Zip ___________________________ Work Phone ____________________________	Home Address Street __________________________________ City/State/Zip ___________________________ Home Phone ____________________________
Preferred Mailing Address? Work _________       Home _________
e-mail address ____________________________________________
___________________________________________________________________________________________________________       Signature                                                                                                                                                                         Date Gale Leadership Development LLC    16416 Agate Point Road NE, Bainbridge Island, WA 98110 Fax number: (206) 842-2691 www.galeleadershipdevelopment.com