Enrollment Process

Collect Payment for Breakthrough Call

Breakthrough Call ($200)

Breakthrough Call ($500)

Collect Deposit Payment

$1000 Nonrefundable Deposit

Collect Payment for Enrollment

Application Accelerator® Bronze

Application Accelerator® Silver

Application Accelerator® Gold

Enrollment Form

Breakthrough Coach Full Name*
Brealthrough Coach Email Address*
Date of Quick Call*
MM slash DD slash YYYY

The $200 paid for the Breakthrough Call can only be applied toward enrolling if the lead enrolls within 30 days of their Quick Call.
Date of Breakthrough Call*
MM slash DD slash YYYY
Engagement Start Date*
MM slash DD slash YYYY

This should be a Wednesday at least 24 hours away.
Full Name of Client*
First Last
Email Address of Client*
Select the call/s the client had prior to purchasing a service*
- Quick Call only
- Breakthrough Call only
- Quick Call and Breakthrough Call
Type of Client*
Number of Applications based on Green Light Guarantee Calculator:
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How many hours did the client purchase?
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How did the client pay their initial payment?
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Upload confirmation of the wire transfer
Max. file size: 50 MB.
Additional notes on the wire transfer payment
Stackable Discounts Client is eligible for*
- $200: Payment for BT Call
- $200: Payment for BT Call with Kaneisha
- $1000: Decisiveness Discount – enrolled within 48 hours of the Breakthrough Call
- Not eligible for any discounts
What is the client's payment plan?
What is the client's other payment plan?
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What is the client's payment plan? Are there any followup actions needed to complete the process of collecting this person's payment(s)?
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How much was the client's initial payment?
Please indicate other mode of payment
Any special bonuses for the client?*
Please indicate bonuses for the client
Which degree(s) is the applicant applying to?*
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What are their career goals?*
List target schools and deadlines discussed on the Breakthrough Call*
Is this client especially anxious or nervous? (i.e regarding deadlines, programs, consultant, etc.)
Has this client expressed a preference for a consultant?
- Yes
- No
Consultant Preference
Referral Source
Name of Referrer
Indicate your other referral source here
Notes from Breakthrough Coach (optional)

Collect Payment for Breakthrough Call

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Collect Payment for Breakthrough Call

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