Mindfulness of Emotions Series 2017
Name:______________________________________ Phone: ( )_________________________
Address:______________________________________________________Zip_____________
E-mail: _____________________________________________ Date:_____________________
Workshop and Classes: ____$80 or ___$70 (AYS member rate) Workshop only: ____$50
To register: Please sign & mail this registration form to Dori at:
4612 So. Schafer Branch Rd, Spokane, WA 99206 with a check payable to Dori Langevin
or a copy of your PayPal receipt. If you prefer to use Pay Pal please add $3 to the price (e.g. $83, $73, $53).
Refunds will be made if Dori is notified by phone by September 24. No refunds after September 24
By registering, I understand and accept the payment and refund policy.
____________________________________________________________ ______________
Signature Date