Company Name *

Contact Name *

Job Title *

Phone *

Email *






Why are you interested in participating? Why is this commitment important to your company at this time?

What potential outcomes or impacts do you anticipate for your company? What do you want to learn or improve?

What are the top three priorities in achieving your company's vision?

What will success look like for your company in 3 – 5 years?

What is the time horizon for your company?

 I commit to being an active participant in the Genesis Movement. I understand this includes attendance at peer learning events, working closely with IMEC staff to create and implement a strategy map, and to pay it forward through a financial donation and invitation of another company. I also agree to participate in impact surveys and evaluation of the process. I understand all data will be held confidentially.