LICENSED PROGRAM APPLICATION

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EMAIL LIZZY NELLI

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919-967-7904

The application below should be completed if you are looking to license your company to conduct our facilitated seminars. Approved licenses are granted to companies versus individuals. Upon receipt of the licensing application, we will be in contact to set up a phone appointment to discuss next steps.

Name
First Last
Company
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Number of employees at your location
Total number of employees company wide
Company Website
Does your company have greater than 50% ownership in any subsidiaries?
- Yes
- No
Please list each qualifying subsidiary.
In which department of the company do you work
How did you hear about Bell Leadership's Licensed Programs?
Length of time you have been with your company
When do you plan to implement this training in your organization?
Number of people you plan to train each year
Please list other training programs you use within your company
Please list any other training programs you are certified to teach
Please list your current responsibilities within your organization
Intellectual Property Statement*
General Information: All seminars required for certification as a licensed facilitator will be held in Chapel Hill, North Carolina, on the University of North Carolina Chapel Hill campus. Chapel Hill is approximately 25 minutes from the Raleigh Durham (RDU) International Airport.

Intellectual Property: We ask that you respect Bell Leadership Institute's copyright. The Bell Leadership training programs, training materials, and marks are owned entirely and copyrighted by Bell Leadership and are made available to licensees only under limited license from Bell Leadership. Licensees shall not make any derivative works whatsoever, unless specific written approval is given by Bell Leadership. Licensees shall not disclose, lend or transfer the Bell Leadership training programs or the training materials to any third party for any purpose. Any unauthorized use of Bell Leadership's training programs, training materials, and marks shall constitute a material breach of the Leadership Training Limited License Agreement.

By selecting the box below, you indicate you have read, understand and agree to the terms of Bell Leadership's Intellectual Property statement.
I have read and understand the terms of Bell Leadership's Intellectual Property statement.
Comments
This field is for validation purposes and should be left unchanged.

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LICENSED PROGRAM APPLICATION

919-967-7904
PO Box 572, Chapel Hill, NC 27514

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