STUDENT SPONSORSHIP REQUESTS
READ BEFORE CONTINUING:

Please fill out this form in it's entirety to be put on a list to be sponsored. Doctors will be able to see your responses and can sponsor students at their leisure.

Note: if you are sponsored and flake on this seminar, your sponsorship will not be passed on to another student. You will be responsible for contacting the Doctor who sponsored you to explain to them why you signed up and failed to attend. ONLY SIGN UP TO BE SPONSORED IF YOU ARE ATTENDING!! NO EXCEPTIONS. *If you have flaked on past seminar sponsorships you will be taken off this list and will be responsible for your own registration fee.

If you are not sponsored by 8AM Saturday, April 27, 2019 you will be responsible for the $75 registration fee.

FIRST NAME *
LAST NAME *
Street address *
City *
State *
Zip *
Email Address *
Phone Number *
SCHOOL *
TRIMESTER/QUARTER *
USING <11 WORDS - WHY HAVE YOU CHOSEN TO STUDY THE GONSTEAD METHOD? *
APPROXIMATE TOTAL HOURS OF GONSTEAD SEMINAR STUDY. *
PLEASE NAME A PRACTICING GONSTEAD DOCTOR YOU LOOK UP TO. *
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