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To apply for this intensive, please submit a recent head & shoulder individual color photo (Emailing a jpeg would be great!) along with your completed registration form and either your deposit or payment-in-full. Please submit all items together at the time of application.
Written homework to be handed in on the first evening of the workshop:
Define: 1. Healing. 2. Compassion 3. Grace 4. Karma
New Students Only: If this is your first intensive with Rosalyn and Ken, please provide the following additional typed information with your registration.
Name_______________________________________________
Address_____________________________________________
City________________________________________________
State/Prov_____________Zip____________________________
Primary Phone__________________________________________
Alternate Phone__________________________________________
Email_______________________________________________
Name for ID Tag______________________________________
Emergency Contact Name__________________________________
Emergency Contact Phone #__________________________________
$1345 Early Bird Fee (due, in full, March 14.) $1395 Regular Fee (due by April 10) -- However, you must pre-register to insure space. $700 Deposit to hold space, balance due according to above dates $260 Additional for single room, due with deposit $25 Additional for gluten-free diet
Check # ______ payable to Jean Hollister and/or
MC Visa Disc AMEX CC#_________________________________ Ex. Date________ Sec. code________
Yes, I will bring a massage table.
Dietary Preference: All foods (chicken or fish option at all dinners) Vegetarian (including dairy & eggs) Vegan ($25 extra) Gluten-free ($25 extra)
I will arrive in time for 6 P.M. dinner on Tuesday.
Room Arrangements: Single (limited #) Double
Roommate Preference____________________________________________ (If you checked double and do not have a roommate preference, one will be provided for you.)
Via Mail: Please mail application materials and payment to:
Jean Hollister1105 Merlot CourtMoore, SC 29369
Email: JeanHollister42@gmail.com
Credit Card Payments: For security if emailing your application, please call me at (513)284-1394, with your credit card number. If using a previously submitted credit card, just write the last 4 numbers only on your application. Please add the new expiration date and security code if it has changed. Thank you, Jean.
Questions? Call Jean at (513)284-1394, or email JeanHollister42@gmail.com.