TV Broadcast Training and/or Coaching

Name *

Today's Date * +

Name of Ministry, church, or organization? *

Email Address ( Required) *

Phone with area code *

Preferred Title *

City *

State *

Name of Television Broadcast. ( If you do not know yet, say "I don't know yet") *

Have you broadcasted on television before? *

Yes

No

Select your preferred choice(s) *

Coaching (Hourly Rate) $189.00

3 Coaching Sessions - $550.00

6 Coaching Sessions - $794.00 ( recommended)

The Works - Professional Coaching and Consulting Services : (4550 fee paid in full OR $3650.00 if broken into 3 payments of $1217.00 per month) 30 sessions

I am interested in financing the $4550.00 in payments of around $350.00 with approved credit) 30 sessions

What is your Facebook address? ( if none state none) *

What is your Instagram address? ( if none state none) *

I authorize PTWWN Broadcasting to process my card payment(s) by phone or from this form. All fees are non-refundable. *

Yes

Signature *

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