On-line Registration

Basic PSYCK-K™  Workshop Registration Form 

Note:  Register before February 1, and take $50.00 off the

Name: 

Address: 

City:    State:   Zip: 

PHONE:      E-MAIL: 

Method of payment:  I will pay on the first day of the Workshop I will pay on-line I have already mailed a check

Cost:  $350 per person and all registrants receive a free book - the missing piece peace in your life; (a $22.00 value) and a PSYCH-K™ manual.