Success Beyond Measure - Helping Woman Leaders
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Application for Success Beyond Measure Women's Retreat

Name:  *
Email Address:  *
Phone Number:  *
Street:  *
City, State:  *
 Zip Code:  *
Date of Retreat:  *
Any special food requirements/allergies:
Sleeping preference: private room double room (twin beds)
I will will not need transportation from the Atlanta Airport
I will be driving Yes No
I would be willing to carpool Yes No
The 3 areas of special interest/focus for me in attending this retreat:
1. 
2. 
3. 
The retreat will be a smashing success for me if:
What did I share with you that convinced you to register for this retreat?
My last physical examination was on
My physical health is excellent average not so great
Payment Method: Pay By PayPal Pay By Check
Payment Amount:
$395.00
$99.00 (this special price is only available to women in the Serenbe community)
Cancellations: If canceling within less than 2 week of the event only half of the total payment will be refunded. If you cancel before the 2 week window then we will refund your full payment.
 

Phone: 770-463-0461
Fax: 770-463-9219
E-mail: Info@PartnershipCoaching.com

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