Registration Form – GoBusiness200/GoLife200

I am registering for:

GoBusiness200GoLife200

Contact Information:

First and Last Name (required)

Your Email (required)

Address

City

State

Zip

Country

Home Phone

Cell Phone

Work Phone

Date of Birth (mm/dd/yyyy)

Your Church:

Church Name (required)

City

Pastor’s Name

Your Family:

Spouse’s Name

Children’s Names

About You:

Level of Completed Education

Employment

Position

Business Type/Industry

Extra-curricular activities

List 3-4 master principles/teachings from your GoBusiness100 or GoLife100 course that had the deepest impact on your life and state how they were used to change your thinking and subsequently, your behavior.

Do you already know someone who is a trained Facilitator that you would like to facilitate you? If so, please indicate their name

Please explain in a 2-3 paragraph essay what you hope to gain from GoBusiness200/GoLife200:

Student Agreement:
As a student, I agree to fulfill my responsibilities to the curriculum and to my Facilitator by participating in all required activities and staying accountable to finish my assignments. I also agree to attend an Intensive before beginning the course. For networking purposes, I authorize the release of my email address to fellow Students & Facilitators only.

PAYMENT: Once your enrollment form is submitted, please complete payment. Your enrollment is not complete until full payment has been made OR you have submitted a Payment Plan and made a deposit.

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