Registration By Regular Mail


You may enroll as an individual, or as a couple.
Your spouse or partner receives a discounted fee of $195.



"How Imperfect Parents Raise Self-Reliant Kids"--Individual Enrollment----$265.00

"How Imperfect Parents Raise Self-Reliant Kids"--Enrollment for Couple---$460.00



REGISTRATION INSTRUCTIONS

PRINT OUT A HARD COPY OF THIS PAGE

FILL OUT THE REQUESTED INFORMATION

ENCLOSE YOUR CHECK, PAYABLE TO JILL SHUGART, MFT


MAIL TO:
JILL SHUGART, MFT
910 TULARE AVENUE
BERKELEY, CA 94707


 

Location and Opening Date of Series You Wish To Attend:

_________________________________________________


Name(s)___________________________________________

Address____________________________________________

City_____________________________________Zip_______

Phone_______________________

Email_______________________________________

Ages of Your Children______________________________



Thank you for your registration! You will receive a confirmation via email promptly upon receipt of this form.

Directions and other seminar information will be provided in a subsequent email.