Recovery Week Enrollment

Confirm your seat in our Recovery Week

TAC Enrollment Form 2021-2022

9/30/2021 GL Cloned from TAC Enrollment 2020-2021 form. Made changes to accomodate Transact payments, particularly in the Opportunity Name and Payment Type
SalesForce pre-populated parameters (Do Not Change!)

SalesForce Record Types - Should not need to be updated
Hidden Calculations

Emergency Contact

Please consider choosing someone who could offer safe emotional support should the need arise. 

Dual Relationships
Please reference your acceptance email and follow the link to our facilitator list. Please provide the name(s) of anyone with whom you have connections and the nature of your relationship.

Enrollment Deposit

Payment Schedule Agreement

The cost of the program may be paid in full or in two or four installments. Payment due dates are available on the offering-specific detail page on our website and in the Covenant & Release of Claims provided in your acceptance email.

Credit Card Information

My signature below certifies that I have read and understand the information provided in the Covenant and Release of Claims. I understand that I am submitting a non-refundable, non-transferrable enrollment deposit that secures my seat and creates a financial commitment. By submitting this Notice of Intent I am willfully choosing to enroll in this offering. parameters (Do Not Change)