Illuminate Colorado
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Circle of Parents Payment Form
Organization/Agency
*
Put N/A if you are not connected to an organization.
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Phone
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Amount
*
Quantity
$250
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Circle of Parents Facilitator Digital Training (Remote)
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10
$300
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Circle of Parents Facilitator In-person Training
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10
$150
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Children's Circle Training/per person
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$200
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Children's Circle - Basic Toolkit
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$300
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Children's Circle - Supplemental Toolkit
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10
$1,000
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Children's Circle - Full Toolkit with Books
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10
$500
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Children's Circle - Full Toolkit without Books
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10
10
If you are taking a training please list all participants.
*
(Name & Email)
Additional Notes
Add 3% to my total amount to help cover the payment processing fees