YOUR TIME IS NOW

Thank you for your interest, in just a few steps you will be registered for:

AN EVENING OF AWAKENING

Friday Evening, April 16 and Saturday, April 17, 2010

Item Name: Full Weekend Event
Time: Friday Evening 7:00 - 9:00 p.m and Saturday 9:00 a.m. - 5:00 p.m.
Pre-Registration Fee: $203.00

All fields required except for Middle Initial, and Comments*

Gender:

Male

Female

First Name: Middle Initial: Last Name: Street Address: City: State/Provence: Zip/Postal Code: Country: Your Email: Confirm Your Email: Phone (home or cellular): (e.g. 555-555-5555)

Phone (cellular): (e.g. 555-555-5555)

How did you hear about us? (please select one)

Payment Method:

	Cash
	Check
	Credit Card
	Pay by Phone

Comments?:

By placing this order, I agree to the Panache Desai Conditions of Attendance, Cancellation Policy, and Privacy Policy.

Panache Desai Events

YOUR TIME IS NOW

AN EVENING OF AWAKENING

Friday Evening, April 16 and Saturday, April 17, 2010