Registration-Short/USA programs

Register for short programs here!

1. Complete all the questions on the registration form below.

2. Submit your non-refundable registration fee of $55. USD
This fee can be paid through the method that is easiest for you: cash, check, money order, or the following link:

UofN LifeReach
or
paypal.me/LifeReach

After sending your Registration form and fee, you will be sent an invoice for the full program fees.
These can be paid through the invoice
OR through the method that is easiest for you: cash, check, money order, or the following link:
UofN LifeReach

If you have further questions, please contact our coordinator Consuelo York
LifeReaching@gmail.com Tel 1.915.225.2257

* Indicates required field

Name *

First

Last

Registering for which Course & Dates? *

Gender *

Male Female

Marital Status *

Single Married

Date of Birth *

Age *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Emergency Contact: Name *

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Last

Emergency Contact: Phone Number *

Do you know your preferred learning method? Consider how you have successfully learned in the past. Choose one or more: *

Visual/Seeing Aural/Hearing Reading &/or Writing Kinesthetic/Movement

How did you learn of this training event? *

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