Please Provide Complete Mailing Address:

Name _________________________________________________________

Address _____________________________________________________

City__________________________State___________________Zip_________

Email___________________________Phone_________________________
(for your confirmation)

Profession___________________

Registration Fees:

_____ $300 Per Person paying with a check
_____ $275 each for groups of 5 or more from the same school or agency, must register together

** if using a purchase order please add a processing fee of $10 per purchase order (sorry no credit cards)

Please mail checks to:

Transdisciplinary Workshops, Inc.
P.O. Box 356
Yarmouth, ME 04096