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Registration | Eros and the Shattering Gaze

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  2. Registration | Eros and the Shattering Gaze
Registration | Eros and the Shattering GazeKenneth Kimmel2017-05-19T04:22:20-07:00

FRACTURES IN THE MIRROR

A Seminar Series with Kenneth Kimmel, Jungian Psychoanalyst

Dates:
Sept 26 & 27, Oct. 10 & 11, Oct. 24 & 25, 2014
Fee:
$405 if Pre-Register by August 15th.
$450 for the 3-Weekend Series
$150 per weekend.
Location:
Talaris Conference Center
4000 NE 41st St
Seattle, WA 98105

Google Map

(Space is limited so pre-registration is encouraged)

Pay By Credit Card or PayPal

To Pay By Credit Card, Click Check Out from the Shopping cart and then underneath the PayPal area is a Pay by Credit or Debit link, simply click that.


Please Choose:









Pay By Check

Please fill out, print and mail your check payment with this form:

    Name:

    Degree & License (for CE):

    Address:

    Street:

    City: State: Zip:

    Email:

    Phone (xxx-xxx-xxxx):

    Please Choose the Dates You Plan to Attend:

    All 3 Days Pre-Reg ($405)All 3 Days ($450)Sept. 26 & 27 ($150)Oct 10 & 11 ($150)Oct. 24 & 25 ($150)

    Amount Enclosed: $

     

    Comments:

    Print This Form
    Click to Print Form.
    Please Make Checks Payable to Kenneth Kimmel, MFT

    Mail Check & This Form To:
    Kenneth Kimmel, MFT
    219 First Ave S, Suite 405
    Seattle, WA  98104

    For further information email ken@nsanpsy.com or call: (206) 447-1895.

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