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Lean Leadership Step 1: Enrollment Information Prefix MrMrsMissMsDrProfRevFrSr Name * Email * Confirm Email * Occupation * AdministratorCommunity Health WorkerDentistNon-Health/PatientNurseNurse PractitionerPharmacistPhysical Therapist/Occupational TherapistPhysicianPhysician AssistantProfessor/TeacherPsychologistPublic HealthRegistered Dietitian/NutritionistResearcherSocial Worker Address * Phone * Step 2: Select a Package Single Member $350 Number of people Enrolling Groups of 2-9 Members $340 Group Size (Include yourself) 23456789 Groups of 10-20 Members $320 Group Size (Include yourself) 1011121314151617181920 Groups of 21+ Members $300 Group Size (Include yourself) 21222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100 Enter Coupon Apply Coupon Discount: $0.00 Total Amount: $350.00 Credit Card Information Name on Card Card Number Expiry CVC Zip Step 3: Enroll Team Members Team Member #1 - Already registered above Team Member #2 Team Member 2 Name Team Member 2 Email Team Member #3 Team Member 3 Name Team Member 3 Email Team Member #4 Team Member 4 Name Team Member 4 Email Team Member #5 Team Member 5 Name Team Member 5 Email Team Member #6 Team Member 6 Name Team Member 6 Email Team Member #7 Team Member 7 Name Team Member 7 Email Team Member #8 Team Member 8 Name Team Member 8 Email Team Member #9 Team Member 9 Name Team Member 9 Email Team Member #10 Team Member 10 Name Team Member 10 Email Team Member #11 Team Member 11 Name Team Member 11 Email Team Member #12 Team Member 12 Name Team Member 12 Email Team Member #13 Team Member 13 Name Team Member 13 Email Team Member #14 Team Member 14 Name Team Member 14 Email Team Member #15 Team Member 15 Name Team Member 15 Email Team Member #16 Team Member 16 Name Team Member 16 Email Team Member #17 Team Member 17 Name Team Member 17 Email Team Member #18 Team Member 18 Name Team Member 18 Email Team Member 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Member 89 Name Team Member 89 Email Team Member #90 Team Member 90 Name Team Member 90 Email Team Member #91 Team Member 91 Name Team Member 91 Email Team Member #92 Team Member 92 Name Team Member 92 Email Team Member #93 Team Member 93 Name Team Member 93 Email Team Member #94 Team Member 94 Name Team Member 94 Email Team Member #95 Team Member 95 Name Team Member 95 Email Team Member #96 Team Member 96 Name Team Member 96 Email Team Member #97 Team Member 97 Name Team Member 97 Email Team Member #98 Team Member 98 Name Team Member 98 Email Team Member #99 Team Member 99 Name Team Member 99 Email Team Member #100 Team Member 100 Name Team Member 100 Email How did you hear about this course? * Email from Clinical Directors Network, Inc. (CDN) Email from Harvard Medical School Center for Primary Care Email from National Association of Community Health Centers (NACHC) Social Media (Facebook, Twitter, etc) Other(Please specify) Submit
