Preregistration for Fall 1996 Workshops

Workshops are scheduled pending sufficient preregistration. Preregistration is due two weeks prior to the workshop date. Print out and mail this form and payment to:

Payment must accompany your preregistration.

I enclose $_______ (check or credit card number) for preregistration for the following:

• ___ Donald Sandner's October 5 workshop, Active Imagination, Mythic Imagination
  ($30 for Society members, $40 for nonmembers, $25 for student/senior members, $35 for student/senior nonmembers)
• ___ John Nicholas's October 19 workshop, Discovering Your Personal Myth
  ($30 for Society members, $40 for nonmembers, $25 for student/senior members, $35 for student/senior nonmembers)
• ___ Please renew my membership to the Society. Dues for one year:
• Single member: $40
• Student/senior member/low income: $25
• Couple (same address): $65
• Sustaining member: $250 - 1,000

Charge my Visa MC Number ___________________________________ Exp. Date ______

Name___________________________________________________________________________

Address_________________________________________________________________________

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