Virtual Intensive Registration

You can register for the June 27th and 28th, 2009 Virtual Intensive by completing the form below and then making a payment using your selected method. Please be sure to include the phone number(s) that you plan to use for the intensive, as we must have this information to confirm your registration. We will email your confirmation of registration upon receipt of payment and one week prior to the intensive you will receive an email with the conference call phone number, access code and other relevant information to ensure successful participation in this virtual event.

(Please note, we do not share our mailing lists or your information with anyone.)

Email address (required):

Name:

Address:

City:

State or Province:

Postal Code:

Country:

Primary Telephone (required):

Alternate Telephone:

I will pay the intensive fee of $200. by the following method:

CoreLight Webstore (a link will be provided when you submit this form)

Charge my card on file ending in

I will mail a check to the CoreLight office.
(CoreLight, 223 N. Guadalupe St. #275, Santa Fe, NM 87501 USA)