You Can Also Use This Form To

2015 IRI Course Enrollment

Welcome. Use can use this form to apply for a course as an alternative to applying for a course directly via our websites and paying with PayPal.

You can also use this form to:

Offer a payment arrangement
Offer a Credit Card or another method to pay for your course

Please enter your details in this adjustable form and return the form to .

Course Fees 2015

Certification for Coaches $1997

Therapist Certification $497

Life Coach Certification $497

6-Figure Coaching Business $1997

Prepare Enrich Certification $250

Personal Details

First Name
Last Name
Best contact number
Email Address
Home Address
Country
Skype or Google + name
Website/Business Name
Current profession
Degrees-Courses-Qualifications
Other Interesting Facts About You ?

Payment Options – Please (x) your option

Do you want to offer a payment plan? (If so, enter your deposit and monthly repayments. Must be paid off by course completion)
Pay by Credit Card? – Enter your card details below
Would you like an invoice to pay us ?We can send you an invoice.

*Prepare Enrich requires payment in full at time of enrolment.

Name On Credit Card
Card Number
CVV (3 or 4 digits on back of card)
Expiration Date
Zip Code/Post Code (billing zipcode)
Country
Monthly amt due (1st of Month) / $
For how many months?
Total

About You

Vulnerability is the key to successful relationships.Our teachers and associates will get real with you. Let us know a little about you.

Why are you interested in this opportunity?
What do you hope to achieve by becoming a coach or certifying with us?
What is your current relationship status?
Have you ever experienced infidelity in your own relationship?
What is your greatest challenge with your own relationship/s?
Do you have any past experience as a coach, teacher or counselor? Please describe. (it's ok if you don't have any past experience). *
Tell us about your strengths and your best qualities.*
Have you ever owned your own business? If yes, describe the business and your results. *
If so , what are some of your current challenges?
What skills need sharpening?
Are you happy with your current income level?
Are you now presently, or have you ever been invested in any business development programs?
As with any career education program, this requires a commitment of time and money. On a scale of 1-10 (10 being highest) how prepared are you to make this commitment to yourself? *
What is the best time of day for you to join in the virtual classroom? What day/s are best for you?
Would you prefer all your course content delivered weekly and work through it at your own pace OR attend virtual classroom?
How many hours per week do you have to put towards this program?
What personal or situational challenges may sabotage you from completing this course?
Do you have a “Study Mate” or do you need to be assigned one?
NOTE: Study Mates work virtually with each other to discuss concepts and role-play.
Is there anything else you want us to know about you?
What are you looking to gain from this course?
What else do you need from us?

Finished?

Please return completed form to :