Please REGISTER NOW Advance Reservations Requested.
Address:____________________________________________________________________
City/State/Zip:_______________________________________________________________
Phone: (______) ___________ __________ Fax: (______) ___________ _________
E-mail address:_______________________________________________________
I want _____ 2-day passes for Barbara Marciniak’s 2009 “Path of Empowerment” workshop in Sedona @ $175 each.
I want _____ 1-day passes for either Saturday or Sunday @ $110 each [Please, circle the day you want!]
$_______ TOTAL AMOUNT, either by enclosed check or by credit card
To secure your reservation today, print this form and fill in the
Credit Card information.
Then Fax the form to: (928) 204-1955. Check one:
Visa:________Mastercard:_________Discover:_________ [No Am Ex]
Card Number:____________ ____________ ______________ ______________
Exp. Date:___________Signature:________________________________________
ALL Credit card payments Must include your Home Telephone Number
A $25 admistrative fee will be taken from ALL cancellations.
NO Refunds given for cancellations after March 1, 2009.
For additonal details, call Dr. Chet Snow: (928) 204-1962.