Register by mail for Bohmian Dialogue

Print this form and mail to:

Inner Workings Resources
PO Box 1264
Helena, MT 59624
406-443-3439

Please fill out the information below accurately.

Name _________________________________

Address _________________________________

City _________________________________

State  _________   Zip  _________

Phone, day   _________________________________

Phone, evening   _________________________________

Email   _________________________________

Workshop Fee:
Full workshop fee is $!50 - Lodging is not included.

Number attending;__________  Please bill my credit card in this amount:   _________

Type of Credit Card:    _________________________________
Credit Card Number:    _________________________________
Expiration Date: Month  _________ Year  _________

Name on Card _______________________________________

Other information:

How did you hear about this workshop? __________________________________________________________

Any other comments or questions?_________________________________________________________________