Executive & Life Coach Training Application

Please fill out the form below. If you have already submitted this information with your application, please just enter your name and phone or email this time.

Online payments are made through PayPal. If you prefer, you may print an application and send it with payment. Download application here.

First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Cell:
Fax:
Email:
	List your prior gestalt training. Please include organization, topic or content, and year of course.

	Purpose: This workshop is very intensive. Describe what you hope to get from this workshop.

	Commitment I understand and accept that: I am responsible for showing up for each session of the workshop, physically and otherwise. I am responsible for fulfillment of the financial obligations of this program including tuition fees and all personal expenses, including travel expenses. I am responsible for completing or reading materials as applicable to the daily topics. I am responsible for taking care of myself as an active member of the community. *No refunds are rendered for cancellation within one month prior to the first workshop.*

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Executive & Life Coach Training Application