SIMI - Scandinavian International Management Institute

Leaders

Leaders application

To apply for the Leaders 2010 program, please fill in the form below or email Program Administrator, Katrine Krog Russo, at kkrusso@simid.k, for a Word-application form.

Please submit your application before 1 May 2010 for early admission or by the final deadline 1 September 2010.

Each applicant is interviewed by telephone to ensure that program prerequisites are met and that program procedures are clear.

PERSONAL INFORMATION

First name*

Middle name

Last name*

Preferred first name

Date of Birth* Nationality*

Gender*

Private Address:

Street*

Zip Code*

City*

State/province

Country*

EMPLOYMENT AND WORK INFORMATION

Company*

Job title*

Company Address:

Street*

Zip Code*

City*

State/province

Country*

Main Phone* Direct phone*

Mobile Phone*

E-Mail*

Website

Parent Company

Nature of business

Description of current duties and responsibilities

No. of people you are responsible for*

WORK EXPERIENCE

Previous positions/employers

Years in current industry* Years of management experience(3+ people)*

Years working while living abroad

HIGHER EDUCATION

Higher Education: Year Higher Education: Institution*

Higher Education: Degree(s)

INVOICE

Person to whom invoice should be sent if not to you

Billing address

Company

Attention

Street

Zip Code

Country

Direct Phone

Yes, I would like to receive information from SIMI by email and be registered in SIMI's database

CONTACT THE PROGRAM DIRECTOR

Jesper Christiansenjchristiansen@simi.dk
Direct tel +45 35 25 30 07