Registration • Six Seconds

Please fill in this form to apply for a Six Seconds’ certification.

For assistance, please contact Jenny Wiley <[email protected]> | +1 831 763 1800

Registrarse para la certificación en español Questions, please contact [email protected]

Certification, Location, Date*
First Name*
Last Name*
Email*
Job Title or Role*
Organization*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Registration fee*
Payment method*
Policies
Please click here to view the Certification License
Please click here to view the Privacy Policy
Please click here to view the Terms of Use
Please checkmark all items to confirm that you agree to these terms*
- I agree to the terms of the Certification License
- I am committed to learning and developing emotional intelligence starting from the inside, so I commit to being an empathic, collaborative, respectful member of the course.
- I will arrange my schedule such that I can fully participate and be fully present through the course, and will leave my phones/devices on "silent mode" and in my bag during the training.
- I will not attempt to video or audio record the course unless I have written permission due to special accommodations.
- I agree to follow the Terms of Use
- I consent to receive emails from Six Seconds and to the terms of the Privacy Policy, including that my personal data may be transferred to another country
Please see above for links to these policies
What are your 2-4 key reasons for wanting to attend?*
Please enter a brief bio (up to 500 characters)*
How did you find out about the program?*
Comment
Phone
This field is for validation purposes and should be left unchanged.

Cancellation Full payment must be received in advance; your registration is not complete until payment has been received and you have received a confirmation of enrollment with the pre-course information. If you cancel with 30 days notice or more, your fee will be refunded less an US$500 processing charge. With less than 30 days, refunds will only be given if your space is filled by another delegate. In the event we cancel, a full refund will be provided, and you will be notified at least two weeks prior to the course.

Policies

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