Choose Your Mentorship Type

GIFT is Available in Online Plus Gatherings (Best Value) and Online-Only

Select Your Learning Environment *

Registrant Information

First Name *

Last Name *

Email *

Mobile Phone *

If you were given a unique code to enter, enter it here.

Unique Code

Help us better understand your goals and aspirations while ensuring we craft a mentorship experience tailored to your needs. Please answer thoughtfully and authentically.

Imagine we are having a conversation three years from today and you're looking back on the impact of GIFT. What would have happened to you personally and professionally for you to feel happy with your progress?
Why are you a good fit for this year's GIFT class?

Primary Address

Street *

Country *

State

City *

Zip / Postal Code *

Province

Billing Address

Billing City

Billing State/Province

Billing Country

Please fill out if different than above address

Background

Your Occupation *

Years In Practice *

Job Title *

Employer *

Date of Birth *

Highest Degree Attained *

Institution Awarding Degree *

Licensure / Certifications *

Related Experience

Referral Information

If a GIFT Fellow personally inspired or significantly influenced your decision to apply for GIFT, please provide their name below. We’re looking for the GIFT Fellow who was solely instrumental in motivating you to take this next step in your journey.

PLEASE NOTE: This should be the individual who directly impacted your decision to apply, rather than simply a GIFT Fellow you may know.

Name of GIFT Fellow

Terms & Conditions

Please Read Our Terms & Conditions (Opens in New Window)

I have read and agree with the Terms & Conditions

Application Fee

After you submit your application, you will be contacted VIA EMAIL by Doug Gray to set up your payment plan and pay your application fee.

I Understand that I will be contacted via email regarding payment of my application fee and I agree to pay the $200 (USD) application fee.
I Hereby Agree to Terms