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This form is for registering with a credit card. Need to pay with a check/purchase order? Click here.

Select the total number of coaches you would like to register with a credit card

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Please fill out this form with information for the person who is coordinating registration or billing.

The quantity you select above will generate your Coach PD Project Membership Seat(s) through our automated system.
The process of setting up your seat(s) can take up to 30 minutes.

Once this happens, you will receive a link to access a management portal where you can let us know who will be participating in the Coach PD Project.

Expect to receive the email with the link to register your coach or team of coaches within 30 minutes from submitting this form.

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Billing Information

Your First Name

Your Last Name

Your Email

Company Name:

Address:

City:

Zip:

Country:

Payment Information

Name On Card:

Card Number

CVC

If the organization that is paying for this membership is different from the company that the coach works for, please identify the funding organization here.

Funding Company or Organization

SUBMIT ORDER