Postal Code: ______________________________________________________
Phone Number: ____________________________________________________
Please book directly with the site. Information about lodging can be found on the Site/Lodging page.
(Fees quoted in US dollars) Please select your choice:
__ $220 - ATI General and Teaching Member
__ $110 - Trainee Member
__ $320 - Non-Member (for individuals new to ATI the price includes General Membership from the start of the AGM through December 2013)
Banquet Sunday Evening, October 28th:
__ $36 - per person
Registration for attending for a single day:
__ $80 - Single day fee for ATI members (one day only permitted at this rate)
If attending for a single day, which day? ___ Monday ___ Tuesday ___ Wednesday
Pre-Day Sponsorship Session on Saturday
__ Yes. I will be attending the Pre-Day Sponsorship Session. ($10.00)
__ No. I don't plan to attend the Pre-Day Sponsorship Session.
__ Not sure about attending the Pre-Day Sponsorship Session yet.
__ I am a Sponsor and plan on sponsoring during the Pre-Day Sponsorship Session.
Total Payment (US$ ONLY) : $___________
Paid by: ___ Check/Money Order ( in US$, enclosed) OR
___ Visa ___ MasterCard Card Number: _________________________________
Expiration Date: ___/____/____
Name as it appears on card (please print): _________________________________________________
Mail with your check, money order in US dollars, or credit card information to :
Alexander Technique International
1692 Massachusetts Ave., 3rd Floor
Cambridge, MA 02138 USA
Fax ( CREDIT CARD PAYMENT ONLY): 617-497-2615
Questions: 1-888-668-8996 (toll-free in USA) or 617-497-5151 or email: email@example.com
Please bring a copy of your registration form with you for confirmation purposes