| The House of La Matrona |
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| Use your credit card and pay with PayPal! Email us at the link below to request an invoice. |
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| HOLISTIC DOULA PROGRAM REGISTRATION FORM |
| I am registering for: Program location __________________________________________________________________________ Program dates ___________________________________________________________________________ **Click here for locations, dates and further information** Name _______________________________________________________________________ Address _____________________________________________________________________ City, State ___________________________________________________________________ Zip Code ____________________ Telephone (_______)_____________________________ Email _______________________________________________________________________ Add me to the Matrona Doulas egroup: _____Yes _____ No Tell us a bit about yourself. Please feel free to use more than the space provided! ____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ The cost of the series is $500. You may pay in full now, or you may choose our payment plan. If you prefer to make payments, a $250 deposit is required at the time of registration. I will be paying: (please check the applicable lines) _______ * in one installment ______ * $250 deposit, with the balance paid in monthly installments in the amount of my choice. I agree to complete my payments no later than the 3rd weekend of class. My deposit or payment of my full balance is: _______ * Enclosed. Check or money order in the amount of $______________ (please make checks payable to Eileen Sullivan) ______ * Credit card payment through PayPal in the amount of $___________ Mail this form to: Matrona Holistic Doula Training c/o Whapio Bartlett 32 Swannanoa Avenue Asheville, NC 28806 We look forward to meeting you and to learning together! |
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