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Institute of Heart Intelligence - Registration Form

Single

Single Early Bird*

Multiple*^

Multiple Early Bird*^

Refresher

Heartskills Melbourne

$395

$345*

$345

$295*^

$100

Passionately Alive (Emotional Intelligence Training) (F&A inc.)

$495

$445*

$445

$445*^

$330

The Art of Loving - for Couples

Couple

Couple

Manhood (F&A inc.)

$495

$445*

$445

$395*^

$250

Leela

$690

$640*

$620

$600*^

$550

Breathworks Training

Plus Accomodation can be paid as you go $50 / weekend

$3800

$3500*

$3300

$3000*^

Concessions and payment terms can be arranged

(F&A not inc./inc. = Food and Accommodation not included / included) All prices (except Breathwork Training) are GST inclusive

* Early Bird price applies only if fully paid two weeks prior. *^Multiple prices apply to multiple bookings paid at the same time.

SPACE IS LIMITED - Fees are to payed in full 7 days prior to seminar. If cancelled less than 5 days prior to Seminar; fees are transferable, non-refundable. Late cancellations for seminars are virtually impossible to fill. Cancellations less than 7 days prior to seminars which leave a vacancy unfilled may be charged in full. Once a seminar starts, fees are non-refundable

Seminar Name:

Seminar Location:

Dates

Name(s):

Phone: (h)

(w)

Mailing Address :

Suburb

Postcode

Email Address:

Payment By: Visa / Master Card / Cheque

Cardholder's Name

Credit Card Number

Expiry Date

Amount Paid

Signature

Please make Cheques To: Institute of Heart Intelligence

To Register: Phone, Post, Fax or Email this form to:

The Institute of Heart Intelligence

P.O. Box 198. The Basin 3154 Ph 03 9739 8889 Fax 03 9739 8885

www.eq.net.au info@eq.net.au

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