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Basic Mediation Training Workshop
Registration & Fees


Complete this form to register.
Fees and mailing instructions are at the bottom of page.

40-Hour Basic Mediation Training Workshops
(Select one with Radio buttons to left)


Washington, DC, August 5-9, 2010
Washington, DC, November 4-8, 2010
Washington, DC, April 7-11, 2011
Washington, DC, August 4-8, 2011
Name:
 

NOTE: Please enter your name as you would like it to
appear on your certificate, including degrees, if you wish.

Address:
City:
State:
Zip Code:
Country:
E-mail Address:
Home Phone:
Work Phone:
Occupation: Attorney  
Psychologist
Educator 
Clergy
Social Worker
Other:
  

   

Basic Mediation Workshop
Registration Fee for Workshops in 2009

Deposit* (due with registration)

$175

Total Early Registration Fee (If deposit received at least 30 days prior to workshop)

$1225

Total fee (if deposit received less than 30 days prior to workshop)

$1325

*Deposit refundable less $25 service charge up to 3 weeks prior to the workshop.
No deposit refunds during the 3 weeks before the workshop.

The full balance is due two weeks prior to the workshop
with no refunds beyond that point.

Make checks payable to:
Mediation Matters
9816 Parkwood Drive
Bethesda, MD. 2081
4


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