Form D: Scheduling a Take Charge of Your Life Workshop

Use this form to make an application to facilitate a workshop. Please indicate if this is the pre accreditation wokshop to complete the mentoring program or a workshop as an accredited facilitator.

First Name *

Last Name *

Country *

Email address *

Dates: *

Location: *

Anticipated participant numbers *

Participant background

Co facilitated with mentor (optional)

Proposed participant fee

Payment to WGI is 10% of your earnings from this presentation.

Please indicate which applies *

I am in the process of becoming an accredited facilitator

I am a fully accredited Take Charge of Your Life Facilitator

Date:

William Glasser International| 4053 W. 183rd St., #2666, Country Club Hills, IL 60478
Phone: (708) 957-6048|membership@wglasser.com