CAS Leading Innovation and Change Registration

Your name *

Your surname *

Your address (street and number) *

Zip Code *

Your location (city/town/village) *

Your country of residence *
---SwitzerlandAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCabo VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe

Your nationality
---SwissAfghanAlgerianAngolanArgentineAustrianAustralianBangladeshiBelarusianBelgianBolivianBosnian/HerzegovinianBrazilianBritishBulgarianCambodianCameroonianCanadianCentral AfricanChadianChineseColombianCosta RicanCroatianCzechCongoleseDanishEcuadorianEgyptianSalvadoranEnglishEstonianEthiopianFinnishFrenchGermanGhanaianGreekGuatemalanDutchHonduranHungarianIcelandicIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJordanianKazakhKenyanLaoLatvianLibyanLithuanianMalagasyMalaysianMalianMauritanianMexicanMoroccanNamibianNew ZealandNicaraguanNigerienNigerianNorwegianOmaniPakistaniPanamanianParaguayanPeruvianPhilippinePolishPortugueseCongoleseRomanianRussianSaudi, Saudi ArabianScottishSenegaleseSerbianSingaporeanSlovakSomalianSouth AfricanSpanishSudaneseSwedishSyrianThaiTunisianTurkishTurkmenUkranianEmiratiAmericanUruguayanVietnameseWelshZambianZimbabwean

Date of birth *

Your email *

Your phone number *

Your current company/institution and position *

Are you working for an iimt partner institution/company (price will be updated according the benefits of the partnership)? *
YesNoI am not sure, please inform me if this is the case

Have you already finished an iimt training programme, and if so, which one?

To obtain the CAS Leading Innovation and Change, you will need to complete 3 modules with the iimt and 1 learning programme with INNOArchitects. Which programme with INNOArchitects would you like to take? *
Product ChampionCustomer Experience FacilitatorStrategy Champion

In which language would you like to correspond with us? *
GermanFrench

How did you get to know us
---Recommendation from friends/work colleaguesGoogle advertisingLinkedIn advertisingiimt websiteInnoarchitects website/coursesCentre for Faith and Society website/coursesFlyerAdvertisement in the newspaperOther

If Other, could you specify which one?

Your CV (upload of PDF allowed) *

Other documents (diplomas, certificates, ... upload of PDF allowed)

Anything else?

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