Workshop Registration Form

*** Please print out this form for you to complete. ***

WORKSHOP REGISTRATION FORM '12

NAME:
_________________________________________

ADDRESS:

_________________________________________

_________________________________________

_________________________________________

_________________________________________

PHONE:
_________________________________________

EMAIL:
_________________________________________

PLEASE WRITE THE WORKSHOP/S YOU WOULD LIKE TO ATTEND

(1) _________________________________________

(2) _________________________________________

(3) _________________________________________

CHECK THOSE THAT APPLY:

( ) I have sent in a donation via check with this form for the workshop/s I would like to attend.

( ) I will send my donation via paypal. http://thegreenwoman.com/paypal.html

ART FOR THE SOUL
13 Classes (2 hours each class) -
$30-$35 per class, or $350-450 (sliding scale)

ROOTS OF SHAMANISM
20 Classes (4 hours each class) -
$35 - $45 per class, or $725-$850 (sliding scale)

WILDCRAFTING & WILD FOODS OF VERMONT

* Make checks payable to The Gaia School of Healing

* Send completed registration form and donation to: The Gaia School, 172 Pine Banks Rd., Putney, VT 05346 617/838-8094; thegaiaschool@gmail.com

Sage L. Maurer
The Gaia School of Healing
172 Pine Banks Rd.
Putney, VT 05346

thegaiaschool@gmail.com
617-838-8094