Register Online 

or download the registration form as a Word® document to complete on your computer.

 Delegate Information

    * Delegate's name:
    If you are registering for someone else, what is your name?
    * E-mail address:
    Phone:
    Fax:
    Mailing address:
    City, State, Zip
    Employer or Organization:
    Job title:
    The following information helps us to plan our sessions to best meet your needs:
    Please provide 1-2 sentences about your experience with using emotional intelligence.
    What are your primary objectives in attending this course?

       

    Your Requested Seminar(s):

    * Which Seminar would you like to attend?(Seminar Schedule)
    Registration fee:
    If it is available for this course, I would like the Service Discount -- here is what I will do to earn the scholarship:
    How did you learn about this course?
    If there are people looking to share a room, would you like us to attempt to connect you? yes!
    If you are coming with other people, how many people are in your group?

    Payment

    * Payment
    Options:
    • Pay with a Visa, Mastercard, or Amex -- provide a $500 deposit online now, and the balance of the fee will be charged 3 weeks before the course.
    • Request an invoice for your school or business.
    • Mail a check.
    If using a purchase order, please enter the PO number:
    Other payment note:

      Any additional comments?


    • When you press "register," this form will be submitted to us by email.

    • If you are paying a deposit online, you will automatically go to the payment page, where you can choose how you would like to pay for the seminar and "check out" from the store.

    • We will email and/or fax you registration materials. If you have any question about your registration, please email us.

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