Please print this page, complete the registration form and send it with your $125 check ($100 for Coda members) made payable to "Coda Alliance" to:
Coda Alliance
2671 Plummer Ave - 29 S
San Jose, CA 95125
Phone or Fax: 408-267-3922
(You may fax the registration if it is less than one week until the course.
If you fax the registration, call to confirm registration and arrange payment)
Date of Respecting Choices course for which you are registering:
NOTE - THERE ARE NO UPCOMING COURSES SCHEDULED AT THIS TIME
Name __________________________________________
Organization/Title ________________________________
Mailing Address __________________________________
City State/Zip ___________________________________
Home Phone _____________________________________
Work Phone _____________________________________
Fax ___________________________________________
Email __________________________________________
An e-mail confirmation and introductory materials will be sent prior to the class
Note: No refund will be given to participants who fail to attend the program without notice. Full refund will be given with at least one week prior notice.