Seminar Registration, Dr. Ofer Zur, Ph.D.

Workshop Registration

You may register NOW online with a credit card OR, if you do not have a forms compatible browser or do not wish to register online, you may print this form and:
•Fax with credit card (Visa or M/C) payment to (707) 935-3918
OR
•Mail with credit card payment or check to:
Dr. O. Zur
Sonoma Medical Plaza
181 Andrieux St., Suite 212
Sonoma, CA 95476.

PLEASE NOTE: The items marked with ** need to be completed.

**First Name:		**Last Name:
**Address:		**City:
**State/Prov:		Country:
**Zip Code:		**E-mail:
**Telephone:		Fax:

PLEASE ENROLL ME IN THE FOLLOWING:

Metaphor of Illness

4/7/01 Corte Madera

Locations and dates are subject to change.

Note: This is not a secure transaction. If you wish, you may fax your registration to 707-935-3918 or mail it to the address below.

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OFER ZUR, PH.D.
Sonoma Medical Plaza 181 Andrieux Street, Suite 212 Sonoma, California 95476	Phone: 707-935-0655 Fax: 707-935-3918 E-mail: drzur@drzur.com
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