PRINT, FILL IN AND MAIL TO: International Association of Past Life Therapists 12400 Ventura Blvd. #116, Studio City, CA 91604 Questions? 818-786-8675 or Toll-free (USA) 800-292-0371 If you prefer, we do accept PayPal. PayPal payment made to ccarbone@earthlink.net (Or, if you prefer, you can email your requests and info.) Dr. Carole Carbone WORKSHOP REGISTRATION FORM Name ___________________________________________ Address __________________________________________ City ___________________ State ______ Zip ____________ Phone (____) ___________________ Date of workshop or workshops desired: (on- site only) 1. _____________ 2. _____________ 3. _____________ Amount enclosed for: Past Life Odyssey Workshop $ ___________________________ Certified Past Life Therapist Training Program $ ______________ Certified E.T. Abduction Counselor Training Program $ _________ Certified Psychic Counselor Training Program $________________ Certified Hypnotherapy Training Program $___________________ Past Life Therapist Facilitator Training Program $______________ Speak Without Fear $_____________________________________ Think Yourself Slender $__________________________________ Stop Smoking Now $_____________________________________ Paid by _____ check _____ money order Mastercard/Visa # ____________________________________ expiration date __________ Signature required for processing __________________________ GO BACK HOME