Personal Details First Name * Last Name * Job Title * Company Name * Direct Phone Number * Cell Phone Number * Email * Company Address * Company Address Line 2 City * Province / State * Postal Code * Country * Canada United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d‘Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Program Choice (Please choose carefully) Which program would you like to register for? * 2-Day Lean Agile Lean Agile Greenbelt Lean Agile Blackbelt Executive Florida Benchmarking Tour Europe Benchmarking Tour Japan Benchmarking Tour (Spring) Japan Benchmarking Tour (Fall) Vancouver Benchmarking Tour In-House Program (Private Session Only) Whitebelt (Public) Whitebelt (Private Session Only) Master Blackbelt Lean Agile 101 2-day Design Thinking Are you a Lean Sensei Greenbelt or Blackbelt graduate? * Yes - Greenbelt Only Yes - Greenbelt and Blackbelt Yes - Blackbelt Only No - Other programs No - Never taken any programs What Lean and/or Agile qualification(s) do you have? Please select all that apply. * Lean 101/Lean Agile 101 Lean Agile Level 1 Lean Agile Level 2 Whitebelt Yellowbelt Greenbelt Blackbelt Master Blackbelt Executive Program Professional Scrum Master (PSM) Certification OtherOther What year did you complete your last certification (either Greenbelt or Blackbelt)? * Program Registration Details Greenbelt Program Location * Virtual Vancouver Calgary/Edmonton Toronto In-House (at your organization) Lean Agile Program Location * 2-Day Lean Agile Level 1 - VIRTUAL 2-Day Lean Agile Level 2 - VIRTUAL 2-Day Lean Agile Level 1 - VANCOUVER TRAINING CENTRE 2-Day Lean Agile Level 2 - VANCOUVER TRAINING CENTRE 2-Day Lean Agile Kaizen - VIRTUAL Whitebelt Program Location * Virtual Vancouver Calgary/Edmonton Toronto In-House (at your organization) Blackbelt Program Location * Virtual Vancouver Executive Program Name * Executive Lean Strategy & Lean Assessment Executive Lean Supply Chain Kaizen Executive Lean Problem Solving Kaizen Executive Lean Sales and Marketing Executive Lean Summit Juku Program Name * Juku Annual Subscription Juku Workshop: VISION 2020 - VANCOUVER TRAINING CENTRE Juku Workshop: VISION 2020 - ONLINE Japan Benchmarking Tour Location * In-person (Japan) Online (Virtual) In-House Program Location * Virtual Vancouver In-House (at your organization) Workshop Program Location * Virtual Vancouver In-House (at your organization) Workshop Program Location Program Season (Check our calendar for correct season) * Summer 2022 Fall 2022 Winter 2023 Spring 2023 How will you be paying? * Credit Card Wire Transfer Existing Client Contract with Lean Sensei International Other Unsure / Don't Know What is your jacket size? * Ladies X-Small Ladies Small Ladies Medium Ladies Large Ladies X-Large Ladies XX-Large Mens Small Mens Medium Mens Large Mens X-Large Mens XX-Large Mens XXX-Large What is your shirt size? * Ladies X-Small Ladies Small Ladies Medium Ladies Large Ladies X-Large Ladies XX-Large Mens X-Small Mens Small Mens Medium Mens Large Mens X-Large Mens XX-Large Mens XXX-Large What name would you like to appear on your program certificate? Please be specific * e.g. John Smith, John A. Smith, John Adam Smith, John A. Smith Jr etc. Greenbelt Candidates Only - Have you completed the Myers-Briggs Type Indicator (R) (MBTI) personality inventory? * Yes No If yes, how long ago did you complete the assessment? * 1-12 months ago More than 12 months ago Sponsor's Details Are you being sponsored to complete this program? * Sponsors are usually executive level managers who support and encourage your Lean activity. Usually your sponsor will be your direct supervisor, manager or Lean leader at your organization. Yes No Sponsor's First Name * Sponsor's Last Name * Sponsor's Job Title * Sponsor's Phone Number * Sponsor's Email * If you are human, leave this field blank.