Registration forms must be received no later than 3 weeks prior to program date.

YOUR INFORMATION

Name:

Company:

Address:

Job Title :

City:

Phone #:

State:

E-Mail:

Zip:

Country:

Assistant's Name:

Work Phone #:

E-Mail:

How did you hear about us?

2008 OPEN ENROLLMENT DATES (LED BY A CERTIFIED PERFORMANCE COACH):

Investment:

$4,000.00

January 7-9, 2008
February 4-6, 2008
March 10-12, 2008
April 7-9, 2008
May 19-21, 2008
June 9-11, 2008
July 14-16, 2008
August 11-13, 2008
September 8-10, 2008
October 6-8, 2008
November 10-12, 2008
December 8-10, 2008

2008 OPEN ENROLLMENT DATES (LED BY DR. JIM LOEHR OR DR. JACK GROPPEL) :

Investment:

$5,500.00

January 28-30, 2008
March 3-5, 2008
May 5-7, 2008
May 12-14, 2008
July 21-23, 2008
September 22-24, 2008
November 17-19, 2008

DIRECT CONTACT TO:

Name:

Phone#:

A representative will contact you for payment information. Please provide preferred contact name and phone number.

Cancellation Policy: Individuals who cancel four or more weeks prior to the program will receive a refund minus a $500 cancellation fee. Cancellations less than four weeks prior to the program will result in a forfeiture of 50% of course fee. If rescheduling is done more than four weeks prior to the program, there is no rescheduling fee. Rescheduling less than four weeks prior to program will incur a $500 fee.Rescheduled course must be completed within six months of originally scheduled program date.

9757 Lake Nona Road

Orlando, FL 32827

407.438.9911

info@energyforperformance.com