Coaching Registration 2018-2019

*First Name
*Last Name
Address 1
*City
State
*Zip
*Phone
*Email
*District
I have chosen a coach?
Coach's Name
I need help selecting a coach
*Coaching ($150)

I agree to pay $150 for 6 sessions of coaching. You have the option of paying by credit card when you submit this registration or mailing your check to: Great Plains Conference, Coaching, 1207 SW Executive Drive, Topeka, KS 66615

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