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




EVENING WORKSHOPS '11
REGISTRATION FORM  







NAME:

_________________________________________



ADDRESS:


_________________________________________



_________________________________________



_________________________________________



_________________________________________



PHONE:

_________________________________________



EMAIL:

_________________________________________







PLEASE WRITE THE WORKSHOP/S YOU WOULD LIKE TO ATTEND 




(1) _________________________________________




(2) _________________________________________



(3) _________________________________________



(4) _________________________________________




(5) _________________________________________



(6) _________________________________________







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



 (Suggested Donation is $25-$35. Please pay what you can.)




* 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