I would like to sign up for one of the following Base Modules on an early bird offer ($370 in place of $470): *


 
I would like to do the In-Person Workshop on: *


 
I would also like to sign up for one of the following Specialist Streams on an early bird offer ($690 in place of $970):


 
I would like to do the SCOAP Coach In-Person Workshop:

You can also decide once you are invited to the online learning platform.

 
I would like to do the Neuroleadership In-Person Workshop:

You can also decide once you are invited to the online learning platform.

 
I would like to do the In-Person Neuro OD / HR Workshop

You can also decide once you are invited to the online learning platform.

 
Contact details

 
First name: *

 
Family name: *

 
Contact telephone *

 
Contact address *

 
I agree to the terms and conditions *

Payment is due within early bird deadline.
You may postpone to another start date (month) with 7 days notice.
Activation days can be taken any time in 2018 (but are recommended in the month you take the online course).
Full refund up to 30 days before your course is due to start.
     
 
I would like to pay now by credit card with a $10 discount:

     
 
Early bird price for 2018 courses (until 30.11.2017), {{var_price}}

 
Please enter your Credit or Debit Card number:

 
The CVC number:

(3 or 4 digit security number on the back of your card)
 
The name on your card:

 
Your card's expiry month:


 
Your card's expiry year:


 
Comments or questions:

Thank you! Looking forward to an exciting course with you {{answer_67400322}}!
Further details will follow and an invitation to our learning system for the online modules. Please let us know if you have any questions or want more information.
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