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Client Commitment Form - I am committed to being a Team Building Client of C.O.R.E Coaching starting on the date of________________/06.
- I understand I have two options to pay. (Please initial your choice below) 1. Monthly for _$_____________ _________________
- I understand that if I choose the monthly payment plan, my credit card account will be billed monthly for the above fee
- I understand that my credit card billing and the coaching will begin on the above date.
or
2. Year in Advance for _$__________ or _____________ {no cancellations)
- I understand if I choose the “Year in Advance” plan, I have two choices on how to pay. (Please initial your choice below)
1. I will enclose or mail a cheque for _________________with above date. (Made out to “C.O.R.E Coaching”) ____________
Or
2. I understand my credit card will be billed for ___________________ on the above date. _____________ I understand that I must return my Client Questionnaire with this form to Furber Coaching.
Cancellation Policy
- I understand that if I am paying monthly, to effectively cancel my Commitment to being a Team Building Client I must mail or email my intention to cancel to Furber Coaching. This notice will cause the next credit card payment to be stopped. (Please note: Furber Coaching will be setting up automatic credit card withdrawals as close to the 1st of each month as possible) Name___________________________________________ Office Phone __________________________________ Company________________________________________ Home Phone ___________________________________ Billing Address___________________________________ Cell Phone ___________________________________ City____________________________________________ Email Address _________________________________ State/Prov___________________ Zip/Postal ________________ Credit Card Payment Please by Visa Only Please use this card 1st # _______-_______-_______-_______ Expiry Date (MM/YY) _____/______ Name on Card ____________________________________ Signature ___________________________ Please use this card 2nd # _______-_______-________-_______ Expiry Date (MM/YY) _____/______ Name on Card ____________________________________ Signature ___________________________ C.O.R.E. Coaching: 1 Lakehill Cres., Toronto, Ont., Canada, M1M1E5, Office Phone 647-284-2110, Fax 416-269-1177 sandra@furbercoaching.com
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