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Registration: Dr. Evan's seminars & workshops


Please fill out the order information requested below. Payment information is required before your order will be processed. For full descriptions of the items listed below, please visit the "Books & Gifts" page. If you have further questions, please email us.

Order Books Gifts & Other Inspirational Items

To register for one of Dr. Evan's seminars or workshops,
Please supply the information requested below.

 
Name of Registering Persons:
                            

Number of persons in your group:
Price per person:
$
Subtotal:
$
CA residents add 8.1% sales tax: 
$

Title of Seminar or Workshop for which you wish to register:



** Break Through  $150.00. If you have to miss a class, you can make it up in the next round.

 
Workshop or Seminar Date:

Payment Form
 (*Required)

Name (as it appears on your credit card or check):


Address:*

City:*

State:*
Zip Code:* 

Phone Number:*

Method of Payment:*

Card Number:*

Expires:*

Confirmation E-mail address:*

How did you hear about us? *

   

Final Total for Your Bill (incl. shipping and sales tax*)           
*CA residents only!
 

You should recieve a confirmation within 48 hours. If you have any questions, please call (602)997-1200.

(Expect Book Delivery in 2-4 weeks)

** These items are required twice, because the shipping and billing addresses aren't always the same. Please be sure to fill out both sets of information. Thank you.

If you would prefer, feel free to print out this form and fax your order to us at
(602) 997-0970.

 

All inquiries are confidential
and treated with utmost respect for privacy.


 

 

Dr. Dina Bachelor Evan - Coaching for Individuals and Couples
Telephone: (602)997-1200 FAX: (602)997-0970

Call for appointments, schedule of workshops and personal growth activities, or to be included on our list for mailings and weekly email inspirational messages.