Bring a Partner for 50% Off!Guaranteed to Make a Difference or Your Money Back* Register for the Self-Leadership 1-2-3 Group Coaching Program Now includes FIVE, one-hour, weekly, live webinars, plus all your materials (emailed) and your full VQ Development Assessment Report. These are highly interactive, participatory webinars with "homework" before and after all sessions. All sessions are recorded and made available for online review within 24 hours.Product Name* Select Your preferred Group... Please note, all times are Eastern USA (i.e., New York). Group starting dates are established once we have at least 6 people registered for a new group time slot. Group size is limited to 16 people.Select a group*Wednesdays @ 12PM ETTuesdays @ 1PM ET Since none of the days or times work for you, please let us know in the commentsby selecting "NONE.." we will be able to let you know when new groups are added. If you want to take advantage of current discount or Promo Code, pay now. Otherwise, select Payment Method "NA" below to pay later.Apply a Promo Code (if you have one). Total $0.00 Sponsoring Participant's Full Name*With the Promo Code entered, you're indicating that this registration is for the co-participant / partner of a person already registered in the selected group. Please enter the name of the person who is already registered and who will be this person's co-participant in the program.Participant Information...Name* First Last Email* Enter Email Confirm Email Mobile Phone*Work / Home Phone (include extension as needed)Company (if Applicable)Add a Partner for 50%?Doing this program with a partner adds tremendous value for both of you. Partners must be in the same group. Register and pay for your partner by clicking this box. If you need to register your partner later, register yourself now and call us for instructions. Yes. Add my partner to this registration Co-Participant Information...Partner's Name* First Last Partners Email Address* Enter Email Confirm Email Partner Primary PhonePayment Information...Total $0.00 How do you want to handle payment?*Credit CardPayPalCheckContract #PO #Contact MeNAPre-PaidCredit Card Information* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name Credit Card Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country No payment to be submitted. Indicating "Pre-Paid" means that you believe you have already paid for the program and are now registering for this group. Once we confirm that's the case, we will complete your registration. If that's not the case, please select a different Payment Method.Please make check payable to: Axiogenics, LLC Mail to: Axiogenics, LLC 1818 Stoneleigh Court Sugar Land TX 77479 We will be emailing you an invoice with this information, as well. Note: Your Registration will be finalized one payment is received.Purchase Order Number*Purchase Orders are accepted for payment only from approved companies. Are you on the list? If so, enter your PO #. MAKE SURE YOU HAVE ENTERED A COMPANY NAME ABOVE.After submitting this form, you will be taken to PayPal to complete your payment.Contract Number*If your organization is under contract with us, please enter your contract number. MAKE SURE YOU HAVE ALSO ENTERED A COMPANY NAME ABOVE. Your Registration will be finalized after we have validated the contract #, which could take a day or two.We will contact you as needed to make payment arrangements. Or you may call +1 484-840-1095. *Money-Back Guarantee. All we ask is that you attend all session and show us that you actually did all the work of the program. Are you a robot?