Registration Form

Cohort 8: Course Registration

Complete form below to register for Our Moral Imperative Cohort 8
Name *

First Name Last Name
E-mail *
example@example.com
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Phone Number
Cell Phone *
How did you hear about the workshop?

Web Site Friend/Colleague Online Search Other
BEFORE YOU REGISTER (or immediately afterwards!),

please complete this pre-course Evaluation

(link opens in a separate tab):

Survey
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OMI Course - Full Payment Please select this option if you can pay the course fee in full at this time. Includes fees.
$ 220.00

OMI Course - Partial Payment If you cannot pay the course fee in full at this time, you may make an initial payment of $70 and pay in installments. Includes fees. NOTE: Course attendance will not be approved until account is paid in full ($210).
$ 75.00

Total

$ 0.00
SCHOLARSHIP Request

Click here, then please send an email to ArohaOMI.info@gmail.com with your request and commitment to fully participating in the work of the course. (No payment required; just click Submit.)

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Cohort 8: Course Registration