Personal Self-Actualization Coaching Registration

Congratulations! You have been accepted to receive personalized self-actualization coaching with Dr. Scott Barry Kaufman. He looks forward to working with you to help you realize your full potential and get in touch with your full humanity. Please select a preferred package below.

Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Course Ticket*
- 1 coaching session $1000
- 4 coaching sessions $3,500
- 8 coaching sessions $7,000
How many people?*
Total
$0.00
Credit Card*
Card Details
Cardholder Name

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