Pacific Northwest Society of Jungian Analysts
Jung In Depth - Part II
Professional Development Seminars in Analytical Psychology

Registration Form

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NAME: 

MAILING ADDRESS:   
PHONE #s:     EMAIL:

OCCUPATION:

LICENSE:     DEGREE:

CLINICAL EXPERIENCE:


PLEASE GIVE A BRIEF DESCRIPTION OF YOUR BACKGROUND IN JUNGIAN PSYCHOLOGY:


PAYMENT ENCLOSED (make checks payable to PNSJA):

  $50 Registration Fee (due with registration) and
  $900 Full Tuition OR

  $550 First Installment (registration fee plus partial tuition, due by August 20, 2008)        and
$400 balance (due by Oct. 15, 2008)

TOTAL AMOUNT ENCLOSED: $    DATE:  

To register, or for more information, call Dunbar Carpenter at: (503) 220-0991. Then mail completed registration form and payment to:

Jung in Depth Seminars - Part II
c/o James Soliday, D.Min.
8914 SW Taylors Ferry Rd.
Tigard OR 97223

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