Name*                                                       

Address                                                     

City                                     State              

Zip                       Country                           

E-mail                                                      

*Please also provide the names of additional family members for name tags.

 

All Sessions	U.S.	CAN	# Events	#  Persons	Total Price
Individual Rate	$75	$80
Pre-registration (by Aug 28)	$60	$65
Additional Family Members	$50	$50
Single Sessions
Friday Evening Lecture	$20	$20
Saturday Morning Workshop	$30	$30
Saturday Afternoon Workshop	$30	$30
Total Price

  Check or money order enclosed, payable to Westar Institute (U.S. dollars drawn on a U.S. bank only). To pay by check in Canadian dollars, make check payable to Knox United Church .

Please bill my  Visa  M/C  Discover  AmEx

Card Number                                                

Security Code (Visa)_____________________
       (the last three digits in the signature block on the back of the card)

Exp. Date             Signature                            

Day Phone                                                  

Payment by credit card or by check in U.S. dollars: print, complete, and mail (or fax) this form to:

Westar Institute
P.O. Box 7268
Santa Rosa, California 95407
(707) 523-1323,  (877) 523-3545 tollfree
(707) 523-1350 fax
events@westarinstitute.org

Payment by check in Canadian dollars: print, complete, and mail this form to:

Knox United Church
506 4th Street SW
Calgary, Alberta
Canada T2P 1S7

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