Please complete the following information to order your Pulse: Please enable JavaScript in your browser to complete this form.Your Name *FirstLastYour title/role *Email *Phone number Organization Name *Organization's Address, City, State and Zip Code *If a congregation your Middle Judicatory/Regional Association Reason for using the Pulse *Strategic Planning Leader Search Financial CampaignVitality Check I would like to add the following module(s) (optional):Transition ModuleConflict Resolution Patterns ModuleStrategic Operations ModuleInterpersonal Training ModuleName of Consultant or Interpreter Terms: *I understand and accept the terms of this agreement for running the instrument. I understand that these instruments have been developed by and are the property of Holy Cow! Consulting. I understand, that if I am not paying by credit card today, payment for all services will be due upon receipt of invoice. I understand that payment must be received before final reports are generated. I would like to handle payment by: *Receive an invoice via email to pay by checkPay now by credit card For credit card payments, I would like to pay for: Pulse (Assessment Only) Pulse Assessment + Online Interpretation with HC!CPulse Assessment + Onsite Interpretation* with HC!C*Travel and other expenses will be billed separately Total$ 0.00Credit CardCard NumberSecurity CodeName on CardExpirationMM123456789101112/YY2324252627282930313233MessageSubmit
