Application Form

What is your name?*

What is your email address?*

What are your top 3 goals for the next month?

What motivated you to apply for this retreat, right now?

What are the biggest leadership questions that are stalking you right now?

How committed are you to developing your personal and organisational leadership?

What is your dream future scenario 3 months after you successfully complete Regenesis? Describe it as best you can.

TIP: Write is from the future you: “It's the 1st of October 2024... I can't believe what happened!.... I'm now...”

What makes you think this hybrid retreat container will support you in achieving your vision right now?