Rayner Institute Enrolment

Student Registration Form
First Name*
Student first name
Last Name*
Student last name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student E-mail*
example@example.com
Phone Number*
How did you hear about us?
Are you currently coaching

ClientsFamilyFriendsWork ColleaguesNot at this time
Do you hold a current ICF designation?
By Selecting the Yes box below you are giving us permission to contact you directly for additional communication.*

Yes for all communicationYes for registration and course materials. No news or marketing emails please
Choose your course and payment options below.
When would you like to start your training?*
Select Your Spring, 2023 Course
Select Your Summer, 2023 Course
Select Your Fall, 2023 Course
ACC Courses

ACC Basic - $3,899 CADACC Advanced - $4,899 CADACC Elite - $5,899 CAD
PCC Courses

PCC Basic - $6,999 CADPCC Advanced - $7,999 CADPCC Elite - $9,999 CAD
MCC Courses

MCC Basic - $10,499 CADMCC Advanced - $11,499MCC Elite - $13,499
Payment Options - Payment Plans require an administrative fee as shown below. If you choose a 3, 6, 10 or 12 Month Payment Plan, you will be charged a deposit of $499 CAD and invoiced for the remaining payments.*

Pay in Full - No additional Charge3 Month Payment Plan - $99 CAD (one time admin fee)6 Month Payment Plan - $149 CAD (one time admin fee)10 Month Payment Plan - $199 CAD (one time admin fee)12 Month Payment Plan - $249 CAD (one time admin fee)
Your Total Tuition (CAD)
Amount Due Today

Tuition Due Today

CADDescription

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Student Registration Form