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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		07 October. Thurs. 6:30-8:00pm
		12 October Tues. 6:30-8:00pm
		21 October Thurs. 11:30am-1:00pm
		26 October Tues. 6:30-8:00pm
		04 November Thurs. 11:30am-1:00pm
		09 November Tues. 6:30-8:00pm
		18 November Thurs. 11:30am-1:00pm
		23 November Tues. 6:30-8:00pm
		02 December 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 Fax: 02 9403 7900 Email: info@macquarieinstitute.com

2. Skype Workshop

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