VERBAL JUDO Enrollment Please enable JavaScript in your browser to complete this form.Name (Attendee) *FirstLastCompany / Department Name: *Company / Department Street: *Company / Department City: *Company / Department State: *Company / Department Zip: *Phone Number: *Email: *Billing Contact Person: *Billing Address Street: *Billing Address City: *Billing Address State: *Billing Address Zip: *Billing Contact Phone: *Billing Email: *Confirm Date: *July 20th - 23rd, 2020Four Day Webinar Instructor Course: Three Year Certification: $1695.00 per studentThree Year Re-Certification: $1495.00 per student. Please note, a copy of your certificate must be submitted to [email protected]Payment Options: *Credit Card Payment: Invoice will be emailed to billing email (if different)PayPal: Send payment via [email protected]Purchase Order: Email to [email protected]Check: Mail to Verbal Judo Institute, Inc. P.O. Box 222, Auburn, NY 13021Request W-9OtherMessageSubmit