EXISTENTIAL CERTIFICATION PROGRAM
REGISTRATION FORM 

Copy and paste this form to your email that you are sending to us at cerfitication@schooloftantra.com.  Or print it and fill it out and mail it.  Or if you have received this form in an email, you may fill in this form and return it by clicking "reply" on your email program and filling in the blanks.  If more than two people are registering and you are sending by mail, copy this registration form for additional person or couple and send forms in same envelope.   Tuition is $1000 per person per week.   

School is held every Monday through Friday from 9-5 pm in Maui, Hawaii from September 1st to May 31st.   Limited Accommodations available on campus.  Register early if you wish to stay on campus with us.  Be sure to arrive early to get acclimated before class.  You may wish to stay afterwards to hang out with your new friends and enjoy the beauty of Maui.   


DATE(s) YOU WISH TO ATTEND _________________________    Number of people registering: ______  

EXISTENTIAL CERTIFICATION PROGRAMS:  Click HERE for more on our other CERTIFICATION PROGRAMS

Level

Weeks Class Number
(TO BE ANNOUNCED)
 Class Hours Hours Homework  Interview   $
Practitioner  1

Register me for this program ______

 30 30  1 $ 595 PER LEVEL
CLASSES:  
ELECTRONIC/CORRESPONDENCE CLASS _________  $100.00  (Click here for list of classes)
ELECTRONIC CLASS - IUPS __________  $150.00
TUTORIALS _____  $150/HOUR    I wish to schedule ____ hours

1. NAME PERSON 1: _____________________________________________________ E-MAIL _________________________________
                                                 First                                             Last
TELEPHONE (____)_________________________ (____)____________________ (____)__________________________
                                                Home                                                     Cell                                             Work
ADDRESS: _____________________________________________________________________________________________
                        Street                                                     City                                                             Zip
2. NAME PERSON 2: __________________________________________________ E-MAIL ___________________________________
                                                First                                             Last
TELEPHONE (____)_________________________ (____)____________________ (____)__________________________
                                              Home                                                     Cell                                             Work
ADDRESS: ________________________________________________________________________________________________________
                                             Street                                                     City                                                             Zip
 
Women:    Registration:  $____            Men: Registration:  $ ____             Couple: Registration:  $ ____

Registration method - Option 1.
___ I am confirming my attendance at the Tantra School and will send a check in the mail.  My credit card information to hold my space is below.
If my check does not arrive on time, I prefer Option 2_____  or Option 3 _____.

Registration method - Option 2

___  E-mail or phone in your credit card information  (CC number, name on credit card, expiration date) for a fee of $1050.00   There is a 5% charge for credit card use.

Registration method - Option 3
 ___ The same as in two but let us know that it is only to guarantee your attendance and that you will be paying by cash or check at the door.

Registration method - Option 4
___  E-mail me at ___________________ and we'll generate a PayPal invoice to you. There is a 5% charge for PayPal use.

___  I am coming as a single man and I am not yet gender balanced. Please put me on a waiting list and let me know if there is a single woman to gender balance me.  I will let you know if I find someone to gender balance me.

___  I am coming as a single woman and I am not yet gender balanced. Please put me on a waiting list and let me know if there is a single man to gender balance me.  I will let you know if I find someone to gender balance me.

____  I want to have a private session during my visit.  I wish to reserve _____ hours at $150/hour.  

____  I need accommodations on campus for these DATES _______________    

Please indicate your 1st, 2nd and 3rd choice of accommodations.  You will be sent written confirmation of your reservation.

___ Tent Site ($25/night)   ____ Dorm Space ($35/night)  ____ Loft Room w/Futon ($50 night)  ___  Loft Room w/King Bed ($65 night)  

___ Private Room/Private Bath ($75 night)    

I plan to arrive on DATE __________   TIME _____

PAYMENT BY: _____ CHECK / _____ VISA* / ____MC* / ____ MONEY ORDER _____ 
 

PAYPAL  ______  (Full Tuition Payment $1000)


PayPal Payments are automatically taken from your account every 30 days.  You must make all payments in full before you begin class.  
(2 Payments)   (3 Payments)    (4 Payments)   (5 Payments)   (6 Payments) 
                                          
*Add 5% if you pay by credit card or PayPal

If your check, credit card, or money order is covering anyone other than yourself, please say who you are paying for and give their e-mail address and phone number.

 __________________________________________________________________________________________________________________________

CREDIT CARD INFORMATION
Credit Card payments will appear on your statements as paid to “World Tantra Association”
Add 5% if you pay by credit card


Name on Credit Card (including any middle initial): _______________________________________________________________________________________
                                                   First                                  Middle Initial                                        Last

Complete Billing address on Credit Card ________________________________________________________________________________________________
                                                                                 Street                                                     City                                                             Zip
Credit Card Number: ___________________________________ Expiration date :_____/______/

TOTAL AMOUNT PAID: $ ________  50% DEPOSIT REQUIRED TO HOLD YOUR SPACE.  BALANCE DUE UPON ARRIVAL.


No refunds on the day of the event or 5 days prior to the event.  

CANCELLATION FEES
90 days or more - 25% of price 
60 days or more - 40% of price 
31-59 days - 50% of price 
6-30 days - 75% of price

Mail Registration Form, with check or money order payable, to:
World Tantra Association, 1371 Malaihi Road, Wailuku, Maui, HI  96793 (808) 244-4103

For more information: www.tantraconnection.com
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