In-Sight Institute 2010
Certified Celebrant Registration

Training Location and Date
(see Celebrant Training Locations at www.insightbooks.com)

Location    ________________________________________

Date          ________________________________________

 
Registrant (please print clearly)

Name        ________________________________________

Business   ________________________________________

Position     ________________________________________

Address     ________________________________________

                  ________________________________________

Phone        ________________________________________

E-Mail        ________________________________________

Name as you wish it to appear on training certificate

                  ________________________________________

Payment (payment is due 10 days prior to training or registration may be subject to cancellation)

___       Participant                 $700 3 or more from the same firm $650 each ($550 for Oklahoma City Training)

___       Student                      $350 limit 5 students ($300 for Oklahoma City Training)

___       Refresher                    $400 limit 2 refreshers ($300 for Oklahoma City Training)

Prices are good through 12/31/10
 
Make checks payable to In-Sight Books or charge to VISA/Master Card/American Express/Discover)

Card #       ________________________________________

Amount      ________  Exp Date  ________  Card ID _______

Signature   ________________________________________