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Grip-Birkman SIGNATURE CERTIFICATION, Burlington, ON June 11-13, 2020
Larry and Susan Gay, Facilitators
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Email
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Your email
First Name
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Last Name
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Email
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Street Address (where certificate will be sent)
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CITY
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State/Province/District
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Zip code/Postal Code
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Country
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Phone Number
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Birkman ID (if known. It is NOT recommended to take it again. If you have more than one, share which you prefer we use. If you have doubts, please contact
LarryGay@gripbirkman.com
)
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Preferred name for name tags (eg Bill instead of William)
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Name of person to receive invoice (if different from your own)
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Email address to send invoice
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Which training event are you registering to attend?
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Birkman Signature Certification (Sept 28-Oct 2, 2020, M-F) $2,250 USD (Must have completed GB coach training previously)
Certified Birkman Alumni (Previously completed Birkman Level 1 or Signature Certification) $165 USD
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When did you complete GB Coach training and who was your trainer?
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Have you completed the new Leadership Grip online since January 2017?
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No
Yes
Please indicate any special diet needs or food allergies
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What do you hope to gain from this Birkman Signature Certification through Grip-Birkman?
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Extra Note:
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