<> in the Exquisite Austrian Alps  with Zacciah Blackburn (USA)
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Please call, write or mail to Dinah Arosa at:
Dinah Arosa Marker,  Griesbräustrasse 12, 82418 Murnau, Germany
Tel./Fax (0049)- (0) - 08841-90543,  e-mail: dinah-marker@harmonie-des-seins.de

(Or Zacciah in America:  The Center of Light, PO Box 389, Ascutney, VT  05030  USA,
Phone and Fax:  802.674.9585,  e-mail:  info@sunreed.com )

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Registration Form 

Please fill out and mail, or fax  to Dinah Arosa or Zacciah Blackburn with payment:
With my signature I acknowledge and accept the conditions of this training as set forth in the information pages contained herein.    The amount of € 150.00 ($ 175.US)  I have either:     
(check one)
O     included or mailed by  EuroCheck to Dinah Arosa Marker in this application
O     sent by wire transfer to Dinah Arosa Marker’s account: 
         (Dinah Marker, contact for bank information)
O     included  or mailed  by check or money order ($175. US, deposit; $435 US in full prior to March 12; $450. US there after,)
              to Zacciah Blackburn, or
O    for credit card payment, sent by fax, phone, or secure on line order form
(underline one, must mail or fax signed form) to Zacciah

Name ........................................................................................................................................................................................

Address.....................................................................................................................................................................................

Telephone/Fax/e-mail………………………………………………………………………………………………………….

……………………………………...................         ........................................................................................

            Date                                                                                         Signature

For Credit Card Payment, mail, fax or call with card #, expiration date, name on the card, and your billing address for the card.

Card Number (MC, VISA, or AmEx only:) ....................................................................             Ex Date:  ..........................

Name on Card:  ....................................................  Billing address if different:  .............................................................
                                                                                                                            .............................................................
To register on line, go to our Secure page, and fill in the workshop title on the "instruments' line
(no other fees apply on the secure order form.)

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