Dancing with Dragons Fall Workshop Registration Form
FACILITATED BY: Christine Armstrong, LMFT & Louis Dangles, LMFT
DATE: October 5th, 2019
TIME: 9:15 am - 4:45 pm
LOCATION: Heart Source Center at 1600 Shattuck Avenue, Suite 125, Berkeley, CA 94702

15 spaces still available as of Aug 8th.


COST: $160.00 Early-bird/$175.00 after Aug 30th
Student and/or Elder: $140.00 Early-bird/$155.00 after August 30th

PAYMENT IS MADE BY A SEPARATE INVOICE
>Please note the Registration cost will be invoiced to the email you provide here. Our intention is to send the invoices the next business day. The invoices will be sent in the order participants register online.

>Michelle the EHI Admin Assistant, will send you an invoice through QUICKBOOKS and you will have secure online payment options.

>Spaces are limited so the invoices will be open for a couple of days, if there is any issue please contact Michelle for assistance.

>Payment of your Registration Fee will secure your place at the workshop, please keep your receipt of invoice paid.
Thank you!

Ticket Refund Policy: Full refund minus a $15 admin fee if withdrawal by September 4th; a 50% refund if withdrawn by September 20th. No refund available after September 20th, 2019.

Questions? Contact Michelle, EHI Admin Assistant, at conf@ehinstitute.org

Email address *
Registration Options *
Required
My Information
First Name *
Your answer
Last Name *
Your answer
Credentials (optional)
Your answer
License Type *
Your answer
License # *
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Phone Number *
Your answer
Note to Admin:
Your answer
What does 7 + 2 = ? *
this question is to ensure this registration is used by humans!
Your answer
Workshop Continuing Education Info
The fees above do not include cost for CEs. We have applied for CE sponsorship. Please click below if you would like more information regarding CEs. If so, we will send you a follow-up email about CEs closer to the date of the workshop.
Keep Up to Date with EHI Events & Workshops
EHI Sends Occasional Newsletters and Announcements About Upcoming Events
Subscribe to the EHI Mailing List
EHI Training Programs
EHI has a couple of programs that include an experiential residential training each Spring.
Would you Like More Info About EHI's Training Programs?
Existential-Humanistic Institute Contact Info
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service