Dreaming Beyond Borders Registration

Space is limited. Early registration is recommended.
To register by phone, please call 925-254-0105.

Written and signed request for refunds must be received by October 25, 2002. Conference fee, less a $25 processing charge, will be refunded. No refunds after this date.

(Please Print and return with payment to address below)

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Name	________________________________________________________________

Address _______________________________________________________________

City ___________________	State ____ Zip _________ Phone ___________________

Email ______________________________(for registration confirmation)


One Day Registration(please select one)
____ Saturday, November 2
____ Sunday, November 3

General           $ 125 ____
ASD Member $ 100 ____
Student            $ 75 ____
ASD Student  $ 60

CE Fee $ 10_____

Total $ __________

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Two Day Registration
Saturday and Sunday,November 2-3

General            $ 225 ____
ASD Member  $ 180 ____
Student             $ 135 ____
ASD Student   $ 110 ____

CE Fee $ 10 ____

Total $ _________


Payment by:

 ___ Check: payable to JFKU 

 ___ Credit Card: ____ Visa _____ MasterCard

_____________________________________	_____________
		Card Number		Expiration Date

_____________________________________	_____________
	Signature of Cardholder	                     Total Amount			

Send Registration to:

John F. Kennedy University
Graduate School for Holistic Studies - Dream Conference
12 Altarinda Road, Orinda, CA 94563-2603