Sedona Retreat Registration Form

Sedona Retreat 2007

Registration Form
Please print this form, fill it out and send with your check or money order to:
Mystical Sciences Institute
P.O. Box 1146, Evanston, IL 60204

Date of Retreat:	August 27 thru August 31 Monday thru Friday
Time of Retreat:	See Schedule
Location:	Sedona Arizona
Name
Address
City, State & Zip
Telephone
Email address
Correct name for certificate
Total Amount Submitted	$	Check or Money Order #

Program Fee: $475.00 To secure your registration leave - $100.00 deposit by July 17 2007. All balances are due no later than August 17, 2007.

The fee is only for the workshop. Airfare, Hotel accommodations,
and food are not included.

SAVE $100.00: Register by August 1 2007 and receive a $100.00 early rate discount.Early retreat price is $375 per person.

You will receive a confirmation call following the receipt
of your registration. Visa/MC/American Express accepted.

Office use only
Date Rec'd	initials of staff member recording info
Date Data entry complete	Date confirmation call	date Filed/assigned books & material