Request for Participation
Power Career Development


Please complete the entire form — all fields are required.

You will be required to "copy & paste" your résumé into the last field of the form.



Full Name:
Home Address:
City:
State:     Zip:
Home Phone:   (000-000-0000)
Best Time to Reach:   (include AM/PM and time zone)
Home Email Address:
Title:   Indicate current or last Title or Function
Select Plan: $6,000.00 (USD) Executive Plan
$3,000.00 (USD) Non-Executive Plan
Hourly Plan $250.00 (USD) per hour
Résumé: Copy & Paste Your Résumé into this box
If your résumé is highly formatted, or cannot be copy & pasted,
please tell us you will be emailing it separately as an attachment.
Send it to info@powerseries.us
including your full name and phone number in the body of the email.

Please review your form and confirm that all your information is correct.

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