2017 Beginning CHPC Registration
Use this form to register for the CHPC Beginning Course ~ January 10th-or 17th to April 25th, 2017
Your full name *
Your email address *
Phone *
What is the best way to contact you? *
If you have multiple methods you prefer, use the next question to include another.
If the best way to contact you is by phone, when is the best time to call or text you?
How much will you be paying for CHPC right now? ( You must submit between $20-$100 with this registration form to be in the class. *
The full price (the actual cash value) for CHPC $600, but the Living Love Revolution is committed to making this work accessible, so we have sliding scale, work trades, and gift economy exchanges. You can attend for as little $100 if you are experiencing financial hardship. If you are able to pay full price, however, please choose that option. If none of this makes sense, call Teri Ciacchi 206-612-3511
Required
If you are not paying in full at this time, by when do you intend to pay the balance of your tuition?
Your entire class tuition ( what you can afford and your work trade) must be received in full by March 21st
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Would you like to assist those with financial need by donating to our scholarship fund?
We want CHPC to be accessible to all, regardless of income.
Clear selection
What method will you use to pay the balance of your tuition?
Clear selection
If you are offering a work trade or gift economy trade for some of your tuition, please describe your work-trade proposal or understanding of your existing agreement.
If you do not yet have a work trade or gift economy trade agreement, please speak with Teri Ciacchi
Do you intend to participate from a remote pod ( NOT in SE PORTLAND?)
this question is for anyone who plans to attend remotely using a computer with camera and Zoom App
Clear selection
If you are attending a remote pod, will you need technological assistance to set up the audio visual for the class?
We will assign someone to call you and assist you with this aspect of your participation
If you are attending a remote pod do you already have other participants or will you need assistance finding others to join you?
We will do our best to gather other class participants around you. Please call Teri before Jan 10th to discuss this 206-612-3511
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