Workshop Interest Form

Please check off
Workshop(s) of interest:		 Introduction to EFT Workshop
Making Peace With Food Workshop
Personal Peace Workshop
Habit Breaking Workshop
Phobia Workshop
Easy Breathing Workshop
Name:
Street Address:
City:
State:
Zip Code:
Email Address:
Would you be able to attend the
workshop(s) of interest if it/they
took place in the Boston (MA) area?		 yes     no
If not, would you be interested in
traveling to the Boston (MA) area
for a weekend workshop?		 yes     no
If not, please indicate
one or more locations where you
could go for a workshop: