Date of Birth __________________________ Before/After Sunrise (circle one)
(contact information to be used for retreat purposes only)
Dietary and Special Needs Information:
List any food allergies: ___________________________________________
Are you vegetarian? _________________________________
List any special dietary needs: ______________________________________________
List any other special needs: _________________________________________________
Fees:
$150 non-refundable registration fee is due with this registration form by Aug. 10
Balance of program cost due by August 10, 2009
Total Program Cost (check one):
___ $695 for Full Tuition
___ $600 Discounted Tuition for registering with a friend -- her name is _________________________
___ $550 Tuition for registering with 2 friends whose names are ____________________ and ____________________
___ $495 Work/Study Tuition
Checks for the registration fee should be made out to the
Foundation for Astronomy and Spirituality, Inc. and sent to:
Dr. Joyous Judy Young
Foundation for Astronomy and Spirituality, Inc.
9 McClure St.
Amherst, MA 01002