Application for Tongue Fu

Application for Tongue Fu!® Training Institute (Please print this form.) BACK

You may register by mailing this form (first come – first served) to Action Seminars,
ATTN: Cheri Grimm at P. 0. Box 6810, Los Osos, CA 93412 or fax to (805) 528-2581.

Questions? Call Cheri at our toll free number 800 SAM-3455 or email info@samhorn.com.

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Name	_____________________________________________________________
Company	_____________________________________________________________
Address	_____________________________________________________________
City, State, Zip	_____________________________________________________________

Phone Number	____________________	Fax Number	____________________

E-mail	_____________________________________________________________

Current Position and Primary Job Responsibilities
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Speaking/Training Experience
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Why do you want to become a certified Tongue Fu!® Trainer?
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What additional experience/talents/background do you have that qualify you to become a Tongue Fu!® trainer?
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What do you intend to do with your certification if you successfully complete the Tongue Fu!® Training Institute?

Any other comments on why you'd like to become a certified Tongue Fu!® Trainer?__________________________________________________________________________________________
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Please indicate which type of Tongue Fu! certification you’re applying for:

Tongue Fu!® Internal Trainer . . . This plan is for HR Directors, Personnel Specialists, Customer Service Managers, Employee Relations Coordinators, etc. who intend to use their certification within their organization to teach Tongue Fu!® to employees. The licensing agreement and fee paid for this plan lasts one year from the date of certification. It can be renewed, subject to approval by Sam Horn and/or Cheri Grimm, and upon payment of the annual re-certification fee.
Cost: $3500 _______

Tongue Fu!® Professional Speaker . . . This plan is for entrepreneurs who plan to book paid Tongue Fu!® speaking engagements in the public and private sector. These individuals are welcome to generate and schedule their own fee-paid speaking engagements (i.e., convention keynotes, public seminars, small business workshops), and will also be represented by the Tongue Fu!® Speakers Bureau. The licensing agreement and fee paid for this plan lasts one year from the date of certification. It can be renewed, subject to approval by Sam Horn and/or Cheri Grimm.
Cost: $3500 _______

Method of payment: check _______ (please make payable to Action Seminars)

Credit card # _____________________________________________________
Exp. date _______________________________________________________
Signature _______________________________________________________

A deposit of half the certification fee is to be submitted with your application form. (This will be returned if, for some reason, your application is not approved.)

The balance owed is due one week before the Tongue Fu!® Training Institute.

Refund requests must be made in writing, and will be given (minus a $100 processing fee), up to one week before the TFTI. No refunds given after that time, although the certification can be re-scheduled in case of emergency.

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You may register by mailing this form (first come – first served) to Action Seminars,
ATTN: Cheri Grimm at P. 0. Box 6810, Los Osos, CA 93412 or fax to (805) 528-2581.

Questions? Call Cheri at our toll free number 800 SAM-3455 or email info@samhorn.com.

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