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Lex 2X Exec | Global Leadership Network
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Lex 2X Exec Membership Application

Name(Required)

Email(Required)

Country(Required)

Which Membership Circle do you wish to join?(Required)

C- Suite Circle with 1 to 1 Executive Coaching

C-Suite Circle with Peer Advisory Small Group Executive Coaching

Themis Circle (A) (with 1 to 1 mentoring)

Themis Circle (B) (with peer group mentoring)

Themis Circle (B) with 1 to 1 Executive Coaching Add-on

Themis Circle (A) with 1 to 1 Executive Coaching Add-on

Professional Experience & Level(Required)

C-Suite, Executive Director, Founder, Senior Government or Justice Official, Academic Leader

Deputy Executive, Vice President, Department Head

Mid-level professional 10 + years experience

Late-early career professional 6-9 years experience

Other. Please describe below.

Other(Required)

Field (e.g. Business Executive)(Required)

LinkedIn URL(Required)

Professional Field(Required)

Law

Tech

Other. Please specify your field and sector.

Other(Required)

If you are applying for a C-Suite Circle Membership, please indicate: 1) the number of direct reports you manage and 2) the number of individuals on the overall team you manage.(Required)

If you are applying for a C-Suite Circle Membership, please indicate whether your report to the CEO, or if not, the number of supervisors between you and the CEO/executive leader of your organization.(Required)

I report directly to the CEO/executive leader of the organization.

I do not report directly to the CEO. There are 1-2 supervisors between my position and the CEO/executive leader of the organization.

I do not report directly to the CEO. There are 3 or more supervisors between my position and the CEO/executive leader of the organization.

If you are applying for Themis Circle Membership, please indicate whether your primary interest is in entrepreneurship.(Required)

Yes

No

Are you a member of any other professional organizations? If yes, please indicate which ones (optional question).(Required)

Please indicate your motivations for applying. Check all that apply.(Required)

To obtain executive coaching

To access mentoring

To access education & skills training

To explore or strengthen entrepreneurship

To access a community and/or network

To collaborate and work on initiatives related to legal transformation or women and law

To explore a career transition

Sign me up to receive news and information on upcoming events.(Required)

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