NOTE: Please do not include cabin request on the Registration Form.
Institute Cabin reservations must be made by calling the Education Office only:
(760) 745-9096
Name: ______________________________________________Phone: __________________
Address: ____________________________________________________________________
City/State: _________________________________________________Zip: ______________
Email Address: _______________________________________________________________
Track I Session 1 ____________________________________
Session 2 __________________________________________
Session 3 __________________________________________
Track II ____________________________________________
Track III Session 1 ___________________________________
Session 2 __________________________________________
Track IV ___________________________________________
Tuition: $50.00 per class or 3 classes for $135.00, 4 classes for 175.00,
5 classes for $200.00, 6 classes for $225.00 or 7 classes for $250.00
Number of Classes______ Tuition Total $___________
Payment: Check______ Credit Card______ Cash_____
(No cash if registering by mail)
Number of Classes________ Registration Fee____________ Tuition Total _______________
Payment: Check___ Credit Card___ Money Order___ Cash___ (not if registering by mail)
Visa___ Master Card ___
Credit Card Number _______________________________ expiration date _______
Name of card holder ____________________________
Signature ___________________________________________________________
Emergency Phone Contact ______________________________________________
Registration Information and Fees
Early Registration is until July 17th. A $10.00 late registration fee is charged for registering after July17, 2011.
To register in person or for additional information, the Education Office will be open Sunday
afternoons
(until 2:00 pm) July 10, 2011 and July 17, 2011. Partial refunds are available before July 17, 2011
minus a $10.00 processing fee for cancellation but no refunds after that date.
Payment must be included with application to complete registration.
When registering by mail you may print this form and send to HGSA
Attention: INSTITUTE REGISTRATION.
Harmony Grove Spiritualist Association
2975 Washington Circle
Escondido, CA 92029
(760) 745-9176 ~ Fax (760) 745-3482