test page - v-Teamwork

Important: Read PART A of the Professional Coaching Agreement by clicking HERE

Client Details
Client: First & Last Names*
Company Name*
Job Title*
Your Best Phone Number*
Email address*
Mailing Address line 1*
Mailing Address line 2
Suburb, State*
Zip/Postcode*
Is your company paying for coaching or are you paying for coaching?*
- My company is paying
- I am paying
If your company is paying, enter the EIN (US)/ABN (Australia) of the company
First & Last Name of Emergency Contact*
Phone Number for Emergency Contact*
Term
The initial term of the agreement is 4 months from the Commencement Date and thereafter reverts to a monthly subscription.
Commencement Date*
Date of first coaching session.
Payment for Services
Coaching Fee
Total Minimum Spend
Signature of Client
Signature.*
Please enter your first and last name. By completing this field with your electronic signature you are agreeing to all preceding Sections. This electronic agreement is a legal and binding document in the State of Queensland, Australia.
Date
Date Format: MM slash DD slash YYYY
Agreement*
- I have read the Professional Coaching Agreement: PART A

Client Details