Group Registration

Group Name:
Group Cost:	$75/person (Payment Information)
Date and Time:	Groups are on Fridays and last 6 Weeks
Preferred Friday:	(Please input a date)
Preferred Time:
Your Name:
Address:
E-mail:
Comments:
Phone:

Early registration is recommened since seating is limited.

All Groups require a pre-group orientation / consultation. Call 618-624-1234 to schedule your 1 hour appointment. Fee: $40

Registration fee is indicated above.

No refunds can be given within 7 days of the seminar start date.

Make checks payable to BirdSong Counseling and send registration fee to:

All seminars are held at the above address, unless otherwise indicated.