Tele-Coaching 2012-2013
Enlarging and ExpandingYour Life


Applications will be reviewed and letter of acceptance sent out by October 1st

Print this application, fill it out and send to:
Good News Publications*PO Box 63715*Colorado Springs, CO 80962
Call if you have any questions 719-598-9291 (Mountain Time zone USA)
Final deadline is October 1, 2012

If you are not accepted your payment will be returned. Present and past members will be accepted first, along with those referred by Coaching members. If you have been referred by a past Coaching member please write their name here.

____________________________________

Payment Options Please Check One:

 ____  1 payment plan of $4000 by October 1, 2012
                 
 ____   Initial payment of $375 by October 1, 2012 remaining payments (the amount decided by you) sent by
           the first of each month for 11 months  


Name: _______________________________________________________

Address: _____________________________________________________

City/State/Zip: ________________________________________________

Phone Number: _______________________________________________

Email: _______________________________________________________

Payment: (Circle one)  Visa * MasterCard * American Express *  Check/Money Order

Card Number: _________________________________________________

Expiration Date: _______  ___________

(Payments can possibly be used for tax purposes as business training expense check with your accountant)


********I would also like to apply for the Spiritual Growth Mentoring Program in Colorado Springs.

_____ I am between the ages of 19 and 29

_____ I will be able to come to Colorado Springs once a week for meetings

_____ I am signing up for the Full-time Coaching program above (if your parents or family are in the Coaching Group you are automatically in as well)

_____ I am open to learn and willing to be open and honest with myself and those in the group

Please put a check in each box above which means you agree with it and sign your name here _________________________________________________

If you have any questions you can email me at DukeClarke@gmail.com or call at 719-598-9291 (Mountain Time)