Basic PSYCK-K®  Workshop Registration Form

Workshop Dates/Location:   

Name: 

Address: 

City:   

State:   Zip: 

PHONE:     

E-MAIL: 

*Two or more registering together can each take off $50 from their total print. Find seven people to register with you and you get your seminar for free!

If registering w/ someone else, please include that person's name here:

Method of payment:  I will pay on-line I have already mailed a check

Cost:  $350 per person and all registrants receive a free book - the missing piece peace in your life; (a $22.00 value) and a PSYCH-K® manual.