TO REGISTER FOR “William Madsen- Collaborative Helping in Action - Winnipeg - September 23rd and 24th 2010 - 9 am to 4:00 pm"

Please fill this form and mail it to Winnipeg Narrative Therapy with a payment either by mail at 82 St Albans Rd or you can pay ONLINE throught paypal

Online: http://www.winnipegnarrativetherapy.com
By Mail: 82 St Albans Rd Winnipeg Manitoba R3Y1W8

Please make cheques payable to Mariana Sussi

Your Information:

*First Name:
*Last Name:
  
Position:
  
Organization:
  
*Address:
  
*City:
  
*Province:
  
*Postal Code:
 
Home Phone: ( )
  
*Work Phone: ( )
  
*Work Fax: ( )
  
*E-mail:
  
*Workshop Title:
  

Comments:

 

 
Payment Options:
Winnipeg - September 23rd and 24th 2010 - 9 am to 4:00 pm
   
Individual Registration
Group (5+) Registration
Early Bird Enrollment
  
$345.45
$329
Registration Until July 30th 2010  
       
Early Bird Student  
$313.94
$299
Registration Until July 30th 2010  
       
Regular Enrollment  
$376.95
$359
   
       
Regular Full time Student  
$334.95
$319
   

Other participant's Names: