I confirm that I am registering for the online Desire Map Level 1 series from April 11 to May 16, 2018. *

Yes

Name *

First Name

Last Name

Phone

(###)

###

####

Which payment option do you choose? *

Uplifter $150

Sustainer $125

Community Energizer $100

How would you like your invoice sent to you? *

Venmo

PayPal

CashApp

If paying by PayPal, do you accept a $2 charge to cover PayPal fees? *

Yes

I will choose a different option