Application and Participant Information

This form is for a group of 4 or more. Note: Your group will consist of individuals that are connected relationally or organizationally.

Once you have completed this form, please click on the submit button at the bottom of this form. You will be contacted by the Lionshare office in regards to further registration and participant payment information.

GROUP APPLICATION INFORMATION:

Select group type:

Friends that desire to take this course together.

A group of people from the same organization.

Group Leader's Name:

Group Leader's Email:

Work Phone (10 digits):

Cell Phone (10 digits):

GROUP ORGANIZATION INFORMATION:

Company/Organization (opt.):

Address (opt.):

City (opt.):

State/Prov. (opt.):

Zip Code (opt.):

Country (opt):

Office Phone (opt.):

GROUP PARTICIPANTS:
(There must be a minimum of three (3) particiants listed IN ADDITION to the group leader.)

Name of Participant 1:

Participant 1 - email:

Participant 1 - Phone No. with area code:

Name of Participant 2:

Participant 2 - email:

Participant 2 - Phone No. with area code:

Name of Participant 3:

Participant 3 - email:

Participant 3 - Phone No. with area code:

Name of Participant 4:

Participant 4 - email:

Participant 4 - Phone No. with area code:

Name of Participant 5:

Participant 5 - email:

Participant 5 - Phone No. with area code:

Name of Participant 6:

Participant 6 - email:

Participant 6 - Phone No. with area code:

Name of Participant 7:

Participant 7 - email:

Participant 7 - Phone No. with area code:

Name of Participant 8:

Participant 8 - email:

Participant 8 - Phone No. with area code:

Name of Participant 9:

Participant 9 - email:

Participant 9 - Phone No. with area code:

Name of Participant 10:

Participant 10 - email:

Participant 10 - Phone No. with area code: