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1½ Hour WORKSHOP APPLICATION - Registration Form

Please fill in the form below. Our staff will contact you to give you more information about the workshop you want to attend and process the payment.

1. Please complete your details

Name

Address

Phone

E-Mail

Schedule: 2010		29 April. Thurs. 6:30-8:00pm
		13 May Thurs. 6:30-8:00pm
		18 May Tues. 11:30am-1:00pm
		20 May Thurs. 6:30-8:00pm
		25 May Tues. 11:30am-1:00pm
		27 May Thurs. 6:30-8:00pm
		1 June Tues. 11:30am-1:00pm
		3 June Thurs. 6:30-8:00pm
		10 June Thurs. 6:30-8:00pm
		22 June Tues. 11:30am-1:00pm
		15 July Thurs. 6:30-8:00pm
		29 July Thurs. 6:30-8:00pm
		3 August Tues. 11:30am-1:00pm
		12 August Thurs. 6:30-8:00pm

Cost of Workshop: $149 inc GST.

Payment by Cheque or Money Order.
Payable to Maquarie Institute
PO Box 1197 Chatswood 2057

Payment by Credit Card: Mastercard Visa

Venue: Macquarie Institute T/A HeartMath Australia
Level 7/6 Help Street Chatswood NSW 2067

Phone: 02 9412 2500 or +61 418 503 727 Fax: 02 9403 7900 Email: info@heartmath.com.au

2. Skype Workshop

Please email me details for attending this workshop via Skype from anywhere in Australia.