Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Payment option *

Which payment option would you prefer. Either the full $1500 or the $750 downpayment must be received prior to the start of class.

Pay the full $1500

Pay $750 and then monthly payments (fully paid by the end of The Encounter cohort)

Have you completed The Divine Design Conference? *

Yes

No

Commitment *

Are you committed to completing The Encounter, readings and other assignments, and mentoring?

Yes

No