GRC Leadership Readiness Program

REGISTRATION FORM – GRC LEADERSHIP READINESS PROGRAM

Participant Info
Your First Name
Your Surname
Email
Mobile Number	Your primary contact number
Whats App Number	Type "0" if you do not have a whats app number.
Linkedin Profile URL	Optional
Date of birth	DDMMYYYY
Gender
City
Country
Zip Code
Do you have a disability?
Educational Info
Professional Certifications	Professional Certifications CIA CRMA CISA CFE other:
Highest Qualification
Employment Info
Employment Status
Current Employer
Job Title	Designation
Department
Program Interest and Motivation
Why are you interested in joining the GRC Leaders Program?
What are your leadership development goals?
Which area of GRC leadership interests you most?	Which area of GRC leadership interests you most? Governance Risk Internal Audit Compliance other:
Administrative Info
Preferred Start Date or Intake
Billing Contact Person
Billing Email Address
Company VAT Number	If applicable
Payment Option
Terms and Consent
Confirmation and Acceptance	Yes Tick the box to confirm that the information provided is accurate and complete, you agree to the program's terms and conditions, and that you consent to the processing of my personal data for program administration purposes.