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?

2009 OPEN ENROLLMENT DATES (LED BY A CERTIFIED PERFORMANCE COACH):

Investment:

$4,000.00

January 19-21, 2009
February 9-11, 2009
March 9-11, 2009
April 20-22, 2009
May 4-6, 2009
June 8-10, 2009
July 13-15, 2009
August 10-12, 2009
September 21-23, 2009
October 19-21, 2009
November 9-11, 2009
December 7-9, 2009

2009 OPEN ENROLLMENT DATES (LED BY DR. JIM LOEHR OR DR. JACK GROPPEL) :

Investment:

$5,500.00

January 26-28, 2009
March 2-4, 2009
May 18-20, 2009
June 1-3, 2009
July 27-29, 2009
September 14-16, 2009
October 5-7, 2009
November 16-18, 2009

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