Online Registration for July 7 - 11, 2008
Neufeld Intensive Level One in Vancouver

To register for the Neufeld Intensive Level One in Vancouver, fill out the following form and then click "Submit" only once. When you have been redirected to the "Thank you" page, you'll know your registration has been received. If you have any questions or problems, please contact Dr. Neufeld's office.

Payment Options: There are two payment options, credit card or cheque. If paying by credit card, the full amount is due upon registration. Please follow the directions after submitting your registration form. If paying by cheque, a deposit of $100 is required to hold a space and the remainder is payable by June 15th. You may postdate the second cheque for the remainder if you wish. Make cheques payable to Growth Concerns and mail to:

    Dr. Neufeld's Office
    2155 West 36th Avenue
    Vancouver, B.C.
    V6M 1L3
First Name*
 Last Name*

Address
 City

Province/State
 Postal/Zip Code
Business Phone

Evening Phone
 Email Address*

Organization or School (if applicable)
 Position or role in the organization or school

Sponsoring Agency (if applicable)
 If requesting a student discount, please provide the name of the program and university enrolled in. ($556 CAD payable by cheque only)

To give Dr. Neufeld an idea of the profile of the participants in the course, it would be appreciated if you could provide us with some additional information.

Educational & professional background

Previous exposure to Dr. Neufeld's material

Role with children



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