“Creating Intimate Connections” Open Workshop Registration

Please use the form below to register for “Creating Intimate Connections”.

Name(Required)

Email(Required)

Cell Phone(Required)

Mailing List

Yes, please add me to your mailing list!

Creating Intimate Connections Registration Options(Required)

Individual Working Space ($595)

Group Space ($475)

Student/Alumni Space ($300)

Creating Intimate Connections Lodging(Required)

No Lodging

Lodging ($170)

Total – Creating Intimate Connections

Payment Method

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Please be patient after clicking the Register/PayPal button. It may take several seconds for the payment to process. Thank you!

Phone

This field is for validation purposes and should be left unchanged.