| Your name: |
| Address: |
| City: |
| State: Zip: |
| Your E-mail: |
| Daytime phone: |
| Evening phone: |
| Your Cellular phone: |
| Special contact instructions: |
| |
| Please select the category and fee that applys for you: |
| |
| Keeping the Love You Find: A Workshop for Individuals |
| $300 if registering by April 4, 2008 |
| $350 if registering after April 4, 2008 |
| How did you hear about this Workshop? |
| Please hit the SUBMIT button, it will then direct you to the next page to purchase via credit card using PayPal. PLEASE NOTE THE AMOUNT YOU ARE PAYING BEFORE HITTING "Submit". (You will need to enter the amount with PayPal). |
| T H A N K Y O U ! |