Two Day Intensive REGISTRATION FORM for check payments ONLY – to pay by credit-card or paypal please click the register now! button on the right sidebar.

To register, please fill out the registration form below and send a check for $450 for the two-day training (or $250 if you are a student or intern) to:

Dan Wile
6119 Acacia Avenue,
Oakland, CA 94618.

We meet at this address (my home/office). I will email acknowledgement of your registration and information about local hotels (and bed & breakfasts) and directions how to get here.

    Your Email (required)

    Name

    Address (required)

    City (required)

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    Zip (required)

    Phone(required)

    License Type

    License #

    License State

    Event Date



    Check Amount

    $


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    For more information, contact Dan at 510-654-7390 or dan@danwile.com.