Ω Calendar of Events
Ω Workshop Events: ex-member
Ω Workshop Events: ex-member agenda
Ω Workshop Events: family
Ω Workshop Events: mental health

Cult Information Bookstore
Conferences

July 11-13, 2003
Estes Park, CO

 

 

Registration Form – Estes Park, Colorado
  All rates are per person
 
  • Registration includes workshop fee, meals (Friday dinner through Sunday lunch) and lodging.
     
  • Directions.
     
  • You may register online at our secure bookstore, or
     
  • You can print the form below and mail or fax it with your payment.
     
  • Your contributions will help us give discounts and scholarships to people needing financial assistance.
     
  • See discount columns for early registration fees.
     
  • Don't forget credit card information at the bottom.
     
  • Scroll down to the form below and fax, mail, or e-mail it to:

    AFF
    P.O. Box 2265 Bonita Springs, FL 34133
    fax: (305) 393-8193
    e-mail: mail@icsamail.com
     

The workshop begins promptly at 3:00 p.m. on Friday and ends Sunday at 3:00 p.m.
   

 

 

 

 

#People

Item

Register By 3/31

Register By 5/31

After 5/31

Calculate Amount Due

 

Double Occupancy

$175

$195

$215

 

 

Single Occupancy

$230

$250

$270

 

Contribution

 

$

Total

$
           

Double Occupancy
Do you want us to assign you a roommate?  [     ] yes   [     ] no
If you have a roommate, please tell us his/her name?

Group Experience
What is the name of the group belonged to?
When did you leave the group?

Payment Methods: Visa, MasterCard, Check (U.S. Funds on U.S. bank):

CC No.                                                          Exp. Date:

Name(s):

Address:

City/State/Zip:

Country:

Phone(s):

Fax:

E-Mail:

 

 
Related Information
Ω Calendar of Events
Ω Workshop Events: ex-member
Ω Workshop Events: ex-member agenda
Ω Workshop Events: family
Ω Workshop Events: mental health