IAAC Membership

Institute for the Advancement of AD/HD Coaching
 

IAAC Order Form

Instructions: Please allow ten minutes of uninterrupted time to complete this process.

  • Complete the Membership form (this page) and click "continue";
  • Accept the Code of Ethics statement and click "continue";
  • On the Paypal page, enter your credit card information or Paypal account information;
  • Follow the Paypal instructions;
  • After you have completed the entire process, you will receive three confirmation emails within ten minutes.
  • If you encounter problems, please contact the IAAC Membership.

 
Membership Type *

Payment System *

Your Name *
Your First & Last name
Your E-Mail Address *
A confirmation email will be sent
to you at this address

ADDRESS INFO
 


Blackberry users: hold the shift key while selecting the right arrow/P key or left arrow/O key to scroll up or down the list.


Choose a Login Name (User ID) *
It must be 4 or more characters in length and may
only contain small letters, numbers, and
the underscore '_'
 check for uniqueness
Choose a Password *
Must be 4 or more characters
Confirm your password *
Enter password again
Directory Exclusion
I DO NOT wish to have my contact information listed on the IAAC website.
Company Name
Name of Company
URL
Business URL
Phone
Business Phone
Directory Content
Select the information you wish the IAAC Directory to include.







Directory Instructions
If you have any specific requests regarding the IAAC directory entry, please specify here.
Academic or other credentials
Provide academic or other credentials earned.
COUPONS
Enter coupon code
if you get any coupon code from advertising,
please enter it here


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