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.
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