Back

Call Sylvia at (415) 454-7308 before sending in payment.

(See individual class for deposit info.)

Please sign me up for the events I have specified.
Enclosed is $ ___________________
Fees fully refundable until two weeks prior;
50% refundable thereafter;  no refunds day of event.

Event 1: ________________________________________
Event 2: ________________________________________
Name:__________________________________________
Address:________________________________________
City/State/Zip:____________________________________
Phone: (h)____________________________
            (w) ___________________________
E-mail: _________________________________________

Please make all checks payable to Sylvia Israel.

Send to:
 
IMAGINE! Center for Creativity and Healing
1924 Fourth Street,
San Rafael, CA 94901

Provider approved by CA Board of Reg Nurses #CEP 11733
and CA Board of Behavioral Science for MFT and LCSW,
Provider #947.