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Print out Registration Form
REGISTRATION FORM

NAME: __________________________________________________

ADDRESS: _______________________________________________

CITY/STATE/ZIP: __________________________________________

TELEPHONE: _____________________________________________

Yes, I want to participate in the seminar.

___One Week ___$1,400.00 per person in 2-person room
___$1,800.00 per person in 1-person room
___Two weeks ___$2,500.00 per person in 2-person room
___$3,200.00 per person in 1-person room
___Three weeks ___$3,400.00 per person in 2-person room
___$4,200.00 per person in 1-person room
___Four weeks ___$4,000.00 per person in 2-person room
___$4,800.00 per person in 1-person room

Please indicate whether you are selecting a 1 or 2 person room. Room availability is limited, so early registration is recommended.
  Please list the name of your preferred roommate. We will do our best to accommodate your selection according to your dates of participation and registration.

Name of preferred roommate:

_____________________________________________________________

ARRIVAL DATE, time, airline, flight number:

_____________________________________________________________

DEPARTURE DATE, time, airline, flight number:

_____________________________________________________________

Please note: Each week package begins on Sunday with a check out on the following Sunday morning. Additional accommodations can be arranged for continued study or vacation after the seminar program ends. Costs are available upon request.

    ALL PAYMENTS MUST BE MADE IN U.S. CURRENCY
via Cash, Bankcheck, Traveler's checks or Money order. Visa and Master Card are available for use only for seminar registration fee and bookstore sales while on the premises of the Center.

MAIL REGISTRATION FORM AND PAYMENT TO:
INNER PERCEPTIONS, INC.
P.O. BOX 2652
KAILUA-KONA, HI 96745, U.S.A.



HOME | DEAR SEEKER | CALENDAR OF EVENTS
REGISTRATION INFORMATION | REGISTRATION FORM | ADDITIONAL INFORMATION
TEACHERS | BOOKS AND LESSONS