Summitry Coaching Registration Form

Please complete registration information below. Check appropriate program for which you wish to register, payment option, and amount enclosed. As appropriate, either enclose check or money order or complete credit card information. For check or money order, mail to: Summitry Coaching c/o PSP, 9912 Business Park Drive, Suite 170, Sacramento, CA 95827 USA. For credit card order, either mail to above address, fax to + 916-364-5511, or e-mail to

First Name: _________________________


Title (Optional): ______________________

Organization (Optional): _____________________________

Mailing Address: ___________________________________________________________

City: ________________________ State/Province: ______

Postal Code: __________

Country: ___________

E-Mail Address: _­­___________________________________

Telephone Number: _______________________


2006 Program for which You Wish to Register:

_____Washington D.C.- May 17-18, July 22-23 & September 26-27, 2006

_____Chicago (Illinois)- August 23-24, October 21-22 & December 5-6, 2006

_____Harpswell (Maine)- June 21-22, August 12-13 & October 10-11, 2006


Payment Option

_________ Option One: $5000 (Total) [$5000 due at registration]

_________ Option Two: $5,500 (Total) [$3000 due at registration/$2500 due at 2nd Workshop]

_________ Option Three: $6000 (Total) [$2000 due at registration/$2000 due at 2nd Workshop/$2000 due at 3rd Workshop]


Payment Method

(Please make payment in U.S. dollars to “The Professional School of Psychology”)


Check Number: ________________ Amount: US$ __________________

___________Credit Card ______________Visa ___________MasterCard

 Check appropriate card type

Card Number: ______________________________________

Expiration Date(mm/yy): ____________


Signature: __________________________________

Name on Card: ________________________________




Coming Soon

The new book
from our CEO and founder,
Suzi Pomerantz

Get a Sneak Peak!


Get notified when the book is released,


Take our FREE quiz
to find out how well you can
Seal The Deal

: Organizational Coaching : Business Coaching : Leadership Development/ Executive Coaching :
: BusinessDevelopment / Sales Coaching : Workshops and Seminars :
Advanced Coach Training / Summitry Coaching : Consulting : Facilitation :
Additional Services Offered by Our Strategic Partners : Contact : About Us: Site Map :
Innovative Leadership International LLC is a member of the International Coach Federation
and subscribes to its principals and practices.
Send mail to with questions or comments about this web site.
Copyright © 1999-2007 Innovative Leadership International LLC