Yes!

I would like to register for the
The Nature of Relationships:
An Advanced Voice Dialogue Training
with Miriam Dyak and Cassandra Cosme De Pree,

3 Weekends in 2010
March 20-21, April 17-18, May 1-2, 2010

Sponsored by The Association For Humanistic Psychology
36 CEC’s available*

Saturday & Sunday, 10am-5:30pm
Redmond, Washington (Seattle area)

This is not a secure method of information transfer.

You have a choice - submit online and call in your credit card information,
or mail in a check, or print this form and mail it in to us via regular mail.

Please call us at 425-753-2490 if would like to register,
or give us your credit card number over the phone.

Name

Street Address

City

State/Province

Postal Code

Best Ph# to reach you

Your e-mail

Yes!

  I am registering for The Nature of Relationships Training: March 20-21, April 17-18, May 1-2, 2010
Cost: $925

 I am a member of AHP
     Cost: $786

 I am repeating The Nature of Relationships Training (available only if class is not full.)
     Cost: $462

 Deposit to hold a place in The Nature of Relationships Training: March 20-21, April 17-18, May 1-2, 2010
Cost: $225 (Balance of Tuition due January 21, 2010)


Please Note: Because of rising costs and the losses we incur when participants drop out, we will no longer be able to refund tuition for trainings. Your tuition can be moved to a future training or workshop minus a $35 processing fee. Deferred deposits will expire after one year.

*CECs are available for an additional fee of $40 – paid at the end of the training.

I am enclosing a check in the amount of: 

Please charge my credit card (VISA/MC) #


Amount


Expires

Name on Card

Today's Date

Please tell us how you learned about this workshop

Do you need CEC's?

Please tell us something about your work and any prior experience with Voice Dialogue.

After filling out this form you may submit it electronically (select Submit button below),
or print it and mail it to The Voice Dialogue Institute,
704 228th Avenue NE #833 Sammamish, WA 98074
To keep your credit card protected, please call in your credit card number
if you submit your registration electronically.
Or, print this form and mail it in with either your check or credit card information.
THANKS FOR YOUR REGISTRATION.

QUESTIONS?  Call us at 425-753-2490 or