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Host a Workshop Information Form
Please fill out the form below and The Coach will be in contact with you within one business day. There is no obligation to host a workshop by filling out this form.

Name:
Company / Organization:
Type of company:
(non-profit, for-profit, church, etc.)
Phone Number:
Email Address:
Address Line 1:
Address Line 2:
City, State
,
Zip Code:
How interested are you in hosting a workshop?
Possible Dates:
(please list all dates you are interested in)

ex: 5/6/06, Dec '05, Summer '06
How many people in your organization are interested in attending?
How many others that you know of are interested?
Additional Comments / Questions:


   
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