Tao of Trauma Leadership Cultivation Registration

Name*

Email*

We have been having problems with certain email providers, including Yahoo and AOL. If your primary email is with YAHOO or AOL, please also leave an alternate email below.

Phone Number*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

BIPOC, LGBTQ+, or First-Generation Immigrant?

In the spirit of cultural transformation through healing, if you are BIPOC, LGBTQ, or a first-generation immigrant, please check this box to receive 25% off fees.

BIPOC, LGBTQ+, or first-generation immigrant

I am making a payment of:

Single payment in full by 2/1 ($1,500)
Two payments due 2/1 and 8/1 ($800 each)
Four payments due by 2/1, 5/1, 8/1 and 11/1 ($425 each)

I am making a payment of:

Fees reflect 25% discount

Single payment in full by 2/1 ($1,125)
Two payments due 2/1 and 8/1 ($600 each)
Four payments due by 2/1, 5/1, 8/1 and 11/1 ($318.75 each)

Other Payment Amount

Enter other (if any) payment amount here.

Payment Method*

Checks should be made payable to "Integrative Healing, LLC" and mailed to Integrative Healing, LLC, PO Box 204, Hyattsville, MD 20781. Receipt of your fee will hold your space.

Credit Card
Venmo (will send separately to @alaine-duncan - last 4 of phone is 4003)

Total

$0.00

Credit Card

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