REGISTRATION

Inner Work for Outer Joy:

A Circle of Trust Retreat for Living Mindfully

June 15-17, 2011

Name

Address

Phone Numbers                                            W                                                      H                                                         

 C

 E-mail

Personal statement: To help us discern how participating will both serve you and allow us to better plan the program, please include a personal statement (not more than two pages) with your registration:

• How you learned about this Circle of Trust retreat;

• Why you are interested in participating, and how you hope to benefit personally and/or professionally;

 • What contemplative practices draw you or are currently or have been part of your life?

Program cost:

_____ $889

My check made to still learning, inc is enclosed with this registration form and my personal statement.

Special Needs: If you have any dietary or other special needs, please let us know as soon as possible, so that we can do our best to accommodate you.

To register send the registration form, personal statement, and a check to:

Dr. Sally Z. Hare,

still learning, inc.,

P O Box 14028

Surfside Beach, SC 29587

See PROGRAMS/RETREATS FOR EARLY REGISTRATION SPECIAL!
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still learning, inc.

CIRCLE OF TRUST RETREAT APPLICATION

Taking Your Inner Work into the Outer World:

Reconnecting Soul and Role October 26-28, 2011