Email:
Title
of workshop you will be attending:
Your
Name:
Address:
Phone:
E-mail
Address:
I
give my permission for my contact info to be shared
with the speakers and other participants.
Yes
No
Birth
Data: (Optional for Astrology Workshops)
Date
of Birth:
(02/18 - month/day)
Year
of Birth:
(1951)
Time
of Birth:
(11:34 am)
Place
of Birth:
(New York, NY, USA)
For
Astrology Workshops only: I give my permission for
my birth data to be shared with the speakers and other
participants at the workshop.
Yes
No
Packages
Full Accommodation Shared Room Astrology or Tarot Package (off-site Tarot attendees also)
~ $1,500 USD
Full Accommodation, Single Occupancy Astrology or Tarot
Package ~ $1,700 USD
Tuition Only Astrology Package (for off-site
participants) ~ $1,200 USD
Young Astrologer Full accommodation Package ~ $1,100
USD
Young Astrologer Tuition-Only Package (for off-site
participants) ~ $800 USD
Shared Occupancy Borobudur Tour (payment in full is required
at registration) ~ $425
Single Occupancy Borobudur Tour (payment in full is required
at registration) ~ $490
I am paying for this package in full
I am making a deposit for this package (minimum deposit $500 USD)
Amount I am paying now:
I will be paying via:
PayPal or Credit Card
Once you submit your
registsration form you will be directed to a page for PayPal payment or credit
card payment via the PayPal site.
*Note:
Due to conversion fees, PayPal is not accepting American Express cards from
Australian residents. Other cards, however are accepted. We are sorry for any
inconvenience this may cause.
Direct Bank Deposit
Santa
Barbara Bank & Trust
2010 Mission Drive
Solvang
CA 93463 USA
tel: (001) 805 688 2511
routing number: 122220593
account number: 21322 201
Swift Code:SBBTUS66 (required if sending funds from outside the US)
Check - (Please make check out to "Evelyn Roberts" and
mail to:)
Evelyn
Roberts
P.O.
Box 783
Los
Olivos, CA 93441, USA
I
learned about the Heaven and Earth Workshops
from: