Confluence Center for
Mediation & Training

Mary Forst Associates

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Training Registration Form

Use this form to register for our Workshops. When we receive the form, we will put you on the class list; when we receive payment, your registration is confirmed.You have two options for paying - by mailing us a check, or PayPal online using a credit card or other Paypal account.

1. If you pay by check, make checks payable to :

Confluence Center for Mediation and Training

Mary Forst Associates
15500-H NW Ferry Road
Portland OR 97231-1355

2. If you wish to pay by credit card via PayPal (an easy, secure internet-based option), you will be provided that opportunity after you submit this registration form.

*required

*Select:

*Name:
Occupation:

Business/Organization:

*Email:

*Mailing Address:
*City: * State: *Zip:

*Daytime Phone :
Evening Phone:
FAX:

*Method of Payment	PayPal
	Check

Cancellation Policy: All cancellations must be received in writing. Full refund of fees will be given if cancellation is received at least 21 days in advance of the first day of training. Within 11-20 days, a non-refundable amount of $150 will be charged. Within 10 days, we regret that no refund can be made. Substitutions will be honored at no extra charge.

*I have read and agree to the above cancellation policy

Confluence Center for
Mediation & Training
15500-H NW Ferry Road
Portland OR 97231-1355
(503) 504-4248
mcforst@confluencecenter.com
The URL for this site is http://www.ConfluenceCenter.com

Confluence Center for Mediation & Training

Mary Forst Associates

~~ Training Registration Form ~~

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Confluence Center for
Mediation & Training

Training Registration Form