Executive Leadership Series

Return of the Masters 2003

Celebrating Ten Years of Unique Leadership Training in Orange County

~ Where Leaders on the Rise Learn from Leaders at the Top ~

ELS 2003 Nomination / Registration
*** Limited to First 50 Nominees***

Please accept nomination of the following individual(s) for participation in the
2003 Executive Leadership Series:
To nominate more than one individual, please duplicate this form prior to filling in information

NOMINEE’S NAME_______________________________________________________________________
TITLE___________________________________________________________________________________
COMPANY______________________________________________________________________________
ADDRESS_______________________________________________________________________________
                  _______________________________________________________________________________
PHONE__________________FAX:___________________EMAIL_______________________________________
Nominated by:___________________________________
Company:_______________________________________
Phone:____________ Email________________________

REGISTRATION TUITION: $495
If a company wishes to sponsor more than one nominee, tuition is $425 for additional registrants.
Orange County Forum Member Discount Rate for Registration Tuition is $395
Orange County Forum Member Discount Rate for additional registrants is $325
For Orange County Forum membership information, please call 949-588-9884 or Go To: www.ocforum.org
Membership Categories: Contributing Partner $150 Sustaining Partner $1000
Silver Sponsor $2500 Gold Sponsor $5000 Platinum Sponsor $10,000

____ We will sponsor the above-named individual - Please accept our payment for registration
____ $495 for first sponsored nominee ____$425 each for ____ additional nominee(s)

____ I am a member of the Orange County Forum - Please accept this payment for registration
____ $395 for first nominee ____$325 each for ____ additional nominee(s)
————————————————————————————————————————————–
Registration Tuition Payment

____ Check Enclosed in the amount of $____________
____ MasterCard / Visa Card #___________________________________________ Expiration:__________
         Name on Card_________________________________________________________________________
         Cardholder Signature____________________________________________________________________

____ Please Bill Me (Registration will be confirmed only upon receipt of payment)
____ Please send Registration and billing information to the nominee named above.

Orange County Forum - 23 Musick, Suite 110 - Irvine, California 92618
Phone: 949-588-9884 Fax: 949-770-2089 OrangeCoForum@aol.com www.ocforum.org