Summit Transformation® Materials Order Form

Summit Transformation® Materials Order Form
Name *

First Name Last Name
Email *
example@example.com
Cell Phone Number *
Please enter a valid phone number.
Materials to be picked up from Jenny or Mailed? *

Picked Up - You will get a copy too Mailed to you for all your students (if teaching live)-you will be sent a copy too Mailed directly to each student (if you are teaching online) -you will be sent a copy too
Date Materials are needed? (Must give a minimum 1 week notice.) The earlier you order, the less shipping costs will be. There is a 72 hour turnaround time from the date the order is received to materials being shipped/ready for pickup. *

Month Day Year
Date
TEACHER'S Mailing Address For Materials (Must give a minimum 1 week notice.) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
What Course Level Materials are Needed? *

Level 1 Level 2 Level 3
Class Date *

Month Day Year
Date
Please make sure to have ALL your students sign the Summit Transformation® Certification Agreement before class begins. Once they do, a certification of completion of the class will be sent to the teacher via email.
I understand the above and understand it is my responsibility as the teacher to ensure all students complete the Summit Transformation® Certification Agreement prior to my class. *

YES
COST:

$97 per student per level plus at cost shipping costs plus $25 handling fee if materials are shipped. If materials are picked up, the $25 handling fee will NOT apply. (Shipping costs will be charged upon shipment of materials.)
NOTE: Instructors will always get a free copy of the materials for each class where there have been any material updates since their last order.
Pease click 'Next' to enter your student information.

Please Enter Your Student names, email addresses, phone, and address (for our records of who is certified) for each student below:
Student 1: Name

First Name Last Name
Student 1: Email
example@example.com
Student 1: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 1: Phone
Please enter a valid phone number.
Add another student? *

YES NO

Student 2: Name

First Name Last Name
Student 2: Email
example@example.com
Student 2: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 2: Phone Number
Please enter a valid phone number.
Add another student? *

YES NO

Student 3: Name

First Name Last Name
Student 3: Email
example@example.com
Student 3: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 3: Phone Number
Please enter a valid phone number.
Add another student? *

YES NO

Student 4: Name

First Name Last Name
Student 4: Email
example@example.com
Student 4: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 4: Phone Number
Please enter a valid phone number.
Add another student? *

YES NO

Student 5: Name

First Name Last Name
Student 5: Email
example@example.com
Student 5: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 5: Phone Number
Please enter a valid phone number.
Add another student? *

YES NO

Student 6: Name

First Name Last Name
Student 6: Email
example@example.com
Student 6: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 6: Phone Number
Please enter a valid phone number.
Add another student? *

YES NO

Student 7: Name

First Name Last Name
Student 7: Email
example@example.com
Student 7: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 7: Phone Number
Please enter a valid phone number.
Add another student? *

YES NO

Student 8: Name

First Name Last Name
Student 8: Email
example@example.com
Student 8: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 8: Phone Number
Please enter a valid phone number.
Add another student? *

YES NO

Student 9: Name

First Name Last Name
Student 9: Email
example@example.com
Student 9: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 9: Phone Number
Please enter a valid phone number.
Add another student? *

YES NO

Student 10: Name

First Name Last Name
Student 10: Email
example@example.com
Student 10: Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Student 10: Phone Number
Please enter a valid phone number.

PLEASE HIT SUBMIT TO SEND ALL INFORMATION.

THANK YOU.
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