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EQ Level 1 Class Registration
Event Timing: January 17th-March 7th
Zoom Link To be Emailed Upon Received Payment
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Participant Name
*
Your answer
Participant Email
*
Your answer
Participant Age
*
14-17
18-24
24-30
30+
What do you hope to gain in this course?
*
Your answer
How committed you are to applying new insights to your daily routine?
*
Not at All
1
2
3
4
5
6
7
8
9
10
Totally Committed to Self-Improvement
How will you know you have met your goals for participating in this course?
*
Your answer
I prefer the class to be (check both if no preference):
*
In Person (Melbourne Beach)
Online
Required
Check ALL time slots that WON'T work with your schedule:
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Mondays @1pm
Mondays @ 7pm
Tuesdays @3pm
Wednesdays @ 10am
Required
I agree to treat myself and others with respect and communicate my needs and opinions appropriately* (*Failure to do so may result in expulsion from class)
*
Yes
Required
I understand that I have to mail a check for $125 to the above address once registration minimum has been met. (Please indicate each participant name on check if you are paying for more than one person on a single check)
*
Yes
Required
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