Leading with EQ-i Registration Page

Please complete this form to register for the Leading with EQ-i Class with Connect the Dots

Full Name *

E-mail address *

Phone number *

My phone number is for my: *

Office

Mobile

Job Title *

Employer *

Mailing Address *

Please tell us what you expect from this class

Previous Experience with an EQ-i Assessment

Have you ever completed an EQ-i assessment before? *

Yes

If yes, approximately when did you have the assessment done?

Please upload a copy of your prior EQ-i assessment

Payment Details

How would you like to pay for this class? *

Credit Card - Check the box, submit this form and then select credit card from the confirmation page.

Send a check - Check the box, then submit this form. Mailing instructions are on the confirmation page.

You must click on the submit button to complete your registration for the class. If you do not receive a registration confirmation page, you are not registered for the class.

Payment must be received by April 15, 2020 to secure your spot in this class.

Please complete this form to register for the Leading with EQ-i Class with Connect the Dots

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