Date:


Your Name: *


Your Email: *


Step One: Registration - I have submitted my Student Registration Form. *

Contract - I have signed and sent my Student Contract. *

Clinician - As a state licensed clinician, I have submitted a copy of my license(s).

Student - As a student pursuing a credential that will lead to a professional license, I have sent a copy of my student ID card.

Educator/Coach - As a coach or health educator, I have submitted a brief (one to two page) application letter describing my goals in learning IGI^sm; my plans for using it; my access to psychological consultation or supervision, if needed; any previous training or experience I've had in counseling or coaching; and a copy of my CV or resume.

Step Two: Choose Courses - I have added the program(s) I desire to my shopping cart.

Promissary Note - If I've chosen an Extended Payment Plan, I have signed and sent my Promissary Note.

Tuition Paid - I have paid full tuition for my program(s) or the first payment of an Extended Payment Plan and chosen shipping method by checking out my shopping cart.

Step Three: Checkout - I have completed and am submitting this form.