Please Provide Complete Mailing Address:

Name _________________________________________________________

Address _____________________________________________________

City__________________________State___________________Zip_________

Email___________________________Phone_________________________
(for your confirmation)

Profession___________________

Registration Fees:

_____ $145 Per Person
_____ $125 Each for groups of 4 or more from the same school, business or agency, must register together

If you are using a Purchase Order there is an additional $10 processing fee for each purchase order

Please mail checks to:

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

(sorry no credit cards)