Health Coach Expedited Enrollment This form allows for expedited enrollment into our Health Coaching program. All the required paperwork will still have to be submitted within the next 30 days. This form allows people who might not be able to do all the paperwork in time, to still start the program on time. By completing this form and making a payment by the end of the day, Saturday, April 4th, you will automatically be credited with the Spring Into Coaching $750 tuition discount (payment plans, included). You will see this discount applied in the form below, after you select your payment option. Payment is required. Any currently offered discounts will be applied once you select your payment option. Once this form is submitted, you will receive a confirmation email with a link to PayPal where you can use a credit card or your PayPal account to make the necessary payment. If you have any questions during this enrollment process, please contact us by email: firstname.lastname@example.org, or by phone: 800.987.7530.Contact InformationName* First Last Email* Enter Email Confirm Email Date Date Format: MM slash DD slash YYYY PhonePayment InformationPayment Option*Select your payment option ...Payment In Full - $6,150.00 (includes $400 in fees)Payment Plan A - $1,499.80Payment Plan B - $2,000.00Discount Price: -$750.00 Total $0.00 Consent*I agree to submit any required paperwork within 30 days of submitting this form. I agree to the consent policy.PhoneThis field is for validation purposes and should be left unchanged.