NEUFELD INSTITUTE - Event Registration Form

Welcome! Once we have processed your payment, we will email you confirmation and orienting information. This normally takes from 1-2 business days.

• Identifying Details:

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  Please provide us with the following information:
  First Name:		Last name:
  City:	Use the province/state and country selectors below for other information.	Email:
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• Background Information

  Your response to the following questions would be greatly appreciated as your answers help in the processing of your purchase.
  How did you hear about this webinar series?
  Have you had any previous exposure to Dr. Neufeld's material?
  What is your role with children?

• Registration Options

  You must pick one of the following options:            

  The fee is

  CAD$

• Please make the cheque payable to 'Neufeld Institute', and send it to:
  

  Neufeld Institute,
  2155 West 36th Avenue,
  Vancouver, BC, Canada V6M 1L3

  Note that we cannot process your registration until the cheque is received and clears our bank.

  

  When you click the 'Register' button below, you will be directed to the site, where you can complete your payment. Note that you do not need an account with them to use a credit card for your payment to us. Click on the Don`t have a PayPal account? option once you get to the PayPal site.

• For security reasons, please enter the pink code into the box at the right:

  9a520

Click here to Register for this Event

(Note that it can take a while for PayPal to respond - it can take as much as ten seconds, so please be patient.)