Application Fee: $500

After submitting your certification application (below), your white paper project will be reviewed by the PALI Certification Board. You will be notified of your approval within 14 business days. If your project is approved, next steps for completing your white paper project will be provided at that time

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* 1. Name (First, Last, MI)

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* 2. Email

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* 3. Complete Mailing Address (#, Street, City, State, Zip)

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* 4. Current Company & Title

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* 5. Please Upload a Complete & Up-to-date Resume

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 6. Participants Supervisor Name/Title/ Email (who has approved the White Paper Project)

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* 7. White Paper Goal Details
Please provide details of the goal(s) that you intend to achieve over the next 12 months. Be as specific and detailed as possible. Explain why you chose this goal and why the goal is important to your organization. Please also detail any expected ROI.

Ex. Reduce contract labor hours by 20%

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* 8. White Paper Project Roadmap for Success
Please provide what actions you intend to take or cause to be taken to achieve your goal. Be specific. Who will be involved inside your organization or outside the organization? What resources or time commitments will be needed? How will the staff be involved? What support will you need from the corporate office? Anticipated time frame for success? Please also describe the PALI leadership learning that you intend to apply to achieving your goal.

Ex. Implement orientation changes and new hire meetings/pulse surveys

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* 9. White Paper Project Measuring ROI
Please provide how you will measure whether you have successfully met your goal. Be specific. What metrics will you use? How will you determine ROI?

Ex. Reduction of contract labor hours by 20% = $600,000 annualized savings

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* 10. How would you prefer to pay for your certification. Depending on your selection below you will receive an email with a link to make a secure payment or an invoice for $500 USD.