Program Registration

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How to Work Less, Produce More, & Still Get the Job Done In A Sensible School Week.
TBC’s 2-Day Program for site and district office administrators, and their secretaries. This program is open to participants nationwide.


Select a Program: (Required)

Your Organization’s Contact: (Required)

Contact’s Phone: (Required)

– REGISTRANTS –

ADMINISTRATOR INFORMATION

Administrator’s First Name: (Required)

Administrator’s Last Name: (Required)

Administrator’s Title: (Required)

Administrator’s Email Address: (Required)

Administrator’s Work Phone: (Required)

Administrator’s Fax: (Required)

Administrator’s Cell Phone: (Required)


SECRETARY INFORMATION

Secretary’s First Name: (Required)

Secretary’s Last Name: (Required)

Secretary’s Email Address: (Required)

Secretary’s Work Phone: (Required)

2nd Secretary’s First Name:

2nd Secretary’s Last Name:

2nd Secretary’s Email Address:

2nd Secretary’s Work Phone:


DISTRICT INFORMATION

District Name: (Required)

School/Department: (Required)

Campus Address: (Required)

Campus City: (Required)

Campus State: (Required)

Campus Postal Code: (Required)

Campus Country: (Required)

– PAYMENT OPTIONS –

Fee will be paid by (please check one): Credit Card Purchase Order Check

CREDIT CARD

VISA MasterCard

Credit Card Number: (Required)

Expiration Date: (Required)

Name as printed on card: (Required)

Security Code (cvv): (Required)


PURCHASE ORDER

Purchase Order #: (Required)

Check #:

Check Amount:

Mail Purchase Orders and Checks to: The Breakthrough Coach, 716 Mill Stream Road, Ponte Vedra Beach, FL 32082 Phone: 904.280.3052 Fax: 904.285.3081

Checks and POs should be made payable to The Breakthrough Coach. Remit payment or PO # to The Breakthrough Coach no later than two weeks prior to the event for which you have registered. Cancellations/No Shows within two weeks of any event for which you are registered will be billed to participant.


SHIP INVOICE/SALES RECEIPT TO:

Organization: (Required)

Department: (Required)

Name: (Required)

Title: (Required)

Mailing Address (Required)

Mailing City (Required)

Mailing State (Required)

Mailing Zip Code (Required)

Phone: (Required)

Email: (Required)


– HOW DID YOU HEAR ABOUT US? –

How did you hear about this program? (Required)

If ‘Other’, please specify:



– CANCELLATION POLICY –

  • If you cancel your registration 31+ business days prior to event, you may receive a full tuition refund
  • If you cancel your registration 30-15 business days prior to event, you will receive a credit to another TBC event within one year of registration
  • If you cancel your registration 14 business days prior to event, or do not show for event, you will receive neither a refund, nor a credit