Adult or Group Registration Form

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Full Name* This field is required.
First Name
Last Name
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Company, school, organization, or group name.
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Address
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Phone Number* This field is required.
Area Code
Phone Number
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E-mail* This field is required.
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Workshop or Product NameSelect the workshop(s) or product(s) you are purchasing. (You may select multiple)
G.R.E.A.T. S.T.A.R.T. Full Session
We V.O.W. Full Session
G.R.E.A.T. S.T.A.R.T. 2-day Crash Course
We V.O.W. 2-day Crash Course
Professional Skills
DestinMe Purpose Planning
Life-onomics: Dollar Decisions
Vision 4 Life Vision Board
Social Media Image Mgmt.
Motivation/Empowerment
Confidence Building
Job Search/Career Development
Other Topic
Life Coaching Session(s)
iCountability Partner Sessions
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Suggestions or topics you would like to be included in the workshop, accountability sessions, and/or life coaching?
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My Products* This field is required.
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My Bag
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My Bag
Great Product Name
$20
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
TaxUSD
SubtotalUSD
Total costUSD
iCountability Partners Premium Monthly Rate (8 sessions per month; 3 month minimum)
$200.00+Remove
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Subtotal: $0.00
iCountability Partners Gold Monthly Rate (6 sessions per month; 3 month minimum) 2
$175.00+Remove
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Subtotal: $0.00
iCountability Partners Silver Monthly Rate (Once per week; 3 month minimum) 3
$145.00+Remove
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Subtotal: $0.00
iCountability Partners Bronze Monthly Rate (Every other week; 3 month minimum) 2
$100.00+Remove
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Subtotal: $0.00
G.R.E.A.T. S.T.A.R.T. Full Workshop (6 weeks - CZD Hosted)
$210.00+Remove
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We V.O.W. Full Workshop (6 weeks - CZD Hosted)
$210.00+Remove
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G.R.E.A.T. S.T.A.R.T. 2-day Crash Course (CZD Hosted)
$125.00+Remove
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Subtotal: $0.00
We V.O.W. 2-day Crash Course (CZD Hosted)
$125.00+Remove
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2-day Workshop + WFLCS + t-shirt (CZD Hosted)
$125.00+Remove
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2-day Workshop + WFLCS + t-shirt (Traveling Workshop - Group 10+)
$85.00+Remove
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1-day Workshop + WFLCS (CZD Hosted)
$75.00+Remove
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1-day Workshop + WFLCS (Traveling Workshop - Group 10+)
$50.00+Remove
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Life Coaching Session (per hour)
$100.00+Remove
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Enter Coupon
Total cost $0.00
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