PACE of Facilitation: Registration Name * First Name Last Name Email Address * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Company * Job Title * What name would you like us to use on your name badge? * What field are you working in coaching, leadership, teaching? * What brings you to this workshop? * Do you have any dietery or other requirements? * Are you happy for us to share your name and email address with the other participants attending this workshop? Yes No I would like to receive your email newsletters Yes please No thank you Thank you! We will be in touch to coordinate your registration payment.
