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This page can be found on the web at the following url:
https://www.leadership.opm.gov/Programs/Management-and-Supervisory-Skills/CMFE/507/Register.aspx

Leadership

Registration

NOTE: This is a pre-registration request only. You are not yet confirmed. Applications cannot be accepted without credit card information (see below) or billable documents. Billable documents can be faxed to 304-870-8078. You will receive notification of status via email within 2-3 business days. All confirmed registrations are final and nonrefundable. Requests for substitutions and transfer to alternative courses or dates will be considered up to four weeks prior to the start of a seminar.

Course Information

Coaching and Mentoring for Excellence

Feb 2, 2009 - Feb 5, 2009 at WMDC
Tuition includes materials, meals and lodging

Select here if you are taking this course as part of the LEAD Certificate Program.

Participant Office Information

No abbreviations please

* First Name:
Middle Initial:
* Last Name:
Maiden Name:
* Your name as it should appear on your certificate:
* Email:
* Last 4 Digits of Your SSN:
Job Title:
* GS Grade or Equivalent:
* Agency/Organization:
* Subagency/Division:
* Dept/Agency Mailing Address:
Floor/Suite/Mailstop:
* City:
* State:
* ZIP Code (#####):
* Country:
* Commercial Phone (xxx) xxx-xxxx:
* Commercial Fax (xxx) xxx-xxxx:
* Priority Code:
Your priority code is a special four-digit code that helps us process your registration. On printed materials, it is located on the top right corner of the mailing label. On electronic materials, it is included in the text of the message. If you do not have a printed piece or electronic message available, please use the code XACZ.

Special Accommodations

Smoking Room
Physically Challenged
Special Dietary Needs

Participant Home Information

Home Mailing Address:
City:
State:
ZIP Code(#####):
Country:
Phone:
Ext.
Fax:
Email:

Tuition Billing Information

Which method of payment do you wish to use? Funded Agency Training Authorization
Agency Contract (Enter Contract Number below)
Credit Card (Enter Credit Card Information below)
Contract #:
Credit Card Number:
Card Type:
Expiration Month:
Expiration Year:
Card Holder Name (As It Appears On Card):
Billing Address:
City:
State:
Zip:
Country:
Phone:
Fax:
Email:

Comments and Questions

Comments and alternative date requests

Submitted By: Participant
Credit Card Holder
Agency Partner
Other
If you chose "Agency Partner" or "Other", please enter a contact email address:

* Indicates a required field

PRIVACY STATEMENT

This information is solicited under the authority of 5 U.S.C. §§ 4115–4118. The primary uses of this information are by the Office of Personnel Management (OPM) to register registrants for the various seminars provided at OPM training facilities, and to administer executive, management, and leadership development programs. OPM may use the information for studies and statistics that will not identify you. The Federal Executive Institute (FEI) Alumni Association may use the information for FEI alumni activities. The information may be disclosed to appropriate Federal, State, or local agencies when relevant to civil, criminal, or regulatory investigations or prosecutions; in judicial or administrative proceedings; to congressional offices; and to Federal agencies for employment or security reasons. To keep our records in order, we request the last four digits of your Social Security Number (SSN) under the authority of Executive Order 9397. This Executive Order requires the use of SSNs for the purpose of uniform, orderly administration of records. Giving us your SSN or any of the other information is voluntary; however, we cannot process your registration if you do not provide the information we request.

U.S. Office of Personnel Management 1900 E Street NW, Washington, DC 20415 | (202) 606-1800 | TTY (202) 606-2532