PLEASE PRINT
| description | cost | amount enclosed |
balance owing |
date and location |
|---|---|---|---|---|
| A Safe Passage- Advanced Practitioner Training |
$175.00 |
|
||
| early registration - A Safe Passage- Advanced Practitioner Training |
$150.00 |
|
||
| certification package with workshop discount |
||||
| certification package without discount |
$50.00 | |||
| distance education course | $350.00 | |||
| trigger card box set: 44 laminated trigger cards for birth planning 3 blank cards 30 potential triggers cards Containment box |
$20.00 | |||
| Totals |
Name: ___________________________
Address:__________________________
City:_____________________________
Postal code:_______________________
Phone:___________________________
Email:____________________________
Dietary requirements: (e.g. vegetarian,...):
________________________________
________________________________
PLEASE MAIL COMPLETED FORM to:
Jodi Hinds c/o Birth Positive
20 Weston St
London ON N6C 1R1
Fees include materials and certificate of completion.
Teaching aids and continuing education supplies will be available for purchase.
Either full payment or a non-refundable deposit of $100 is required with registration.
A charge of $20 will apply to all NSF returned cheques.