NEPPA Vistage Inside Group Registration


Please fill in your registration information below.


Contact information:

Please describe your basic job responsibilities, including the number of staff you supervise, and why you want to participate in the Vistage program below:

Payment Information:

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By submitting this application, you are committing, if selected, to attend the four in-person group meetings, participate in collaborative group conversation, and uphold an atmosphere of respect and confidentiality.


In order to submit the registration check the box below to confirm that you agree to the “per person” cost of the selected program and acknowledge that if the event is cancelled NEPPA will credit any payment made, either in full or pro-rated, depending upon the program.