CyberLX Participant Form

Participant Requirements and Enrollment Form

Congratulations on your selection to be a part of The Cyber Leadership Experience (The CyberLX)! This nine-month learning journey facilitates the development of high-potential cybersecurity leaders such as yourself, bringing you highly engaging workshops and valuable leadership connections with peers and mentors nationwide. The CyberLX will develop your leadership skills, expand your professional network, and empower you to take the next step in your career.

Participant Expectations

Have the desire, commitment, and capacity to learn and apply (a growth mindset). The more you invest, the greater the ROI for you and your company.
Aspire to take on significantly expanded responsibilities within 1-3 years and to be in a role of senior leadership.
Actively participate in and complete all required program components, including but not limited to:
- A self-assessment in IT Skill Builder at the beginning and end of the program
- Three (3) virtual workshops
- Three (3) virtual peer problem-solving sessions
- Three (3) virtual meetings with a mentor
- The CyberLX Capstone: Creating and implementing a real-world cybersecurity marketing plan at your organization

Payment

You will receive an invoice for your program fees via email. Payment is due in full before the program begins.

We’d like to learn a bit more about you and your interest in the program.

Please complete the form below. This information will used for the sole purpose of enrolling you in The CyberLX and bringing you a personalized leadership development experience. All fields are required.

IMPORTANT:

The email address you provide on this application will be your unique CyberLX identifier as well as the contact address for all email communications related to The CyberLX.

Applicant Name

Job Title

Company Name

Applicant Phone

Applicant Email

State/Province

Direct Manager Name

City

Country

Direct Manager Email

Executive Sponsor Name

Please specify whether you manage individual contributors or other “people managers“:

I manage individual contributors

I manage “people managers”

I do not manage anyone at this time

Summary of Current Role and Responsibilities (include the size and function area of your team):

How many years have you been at your current company?

What are your career aspirations for the next 1-3 years?

What do you hope to gain as a result of participating in The CyberLX? Are there any particular skills you want to improve?

How do you hope to contribute to the experience of others within The CyberLX?

Please list three to five topics, areas, and/or issues you would like to learn from/discuss with your CyberLX mentor.

What is a fun/interesting fact about yourself that wouldn’t be found on your LinkedIn profile?

Within The CyberLX program, it is understood by all that the mentoring relationship that occurs will be a benefit to the cybersecurity community as a whole. By checking the box below, you agree that neither mentors nor participants shall, directly or indirectly, solicit for employment or any independent contractor relationship from anyone in the program.

I agree

Questions? Need additional assistance?

Contact Bethany Dustin:

603-623-7373 or bdustin@ouellette-online.com

Ouellette & Associates