Registration Form - MENOBUNDANCE Events
Please use this form to register for upcoming residential retreats with Claudia Citkovitz and Lisa Taylor-Swanson
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Registration Information
Which Event are you registering for?   *
First Name *
Last Name *
Business Name (if applicable)
Address *
City *
State/Province *
Zip/Postal Code *
Phone Number (Cell) *
Email Address *
Date of birth  -  this is necessary to register you with the hospital and will be destroyed after use. *
First 4 digits of Social Security number (email last 5 to StudyingPractice@gmail.com).  This is necessary to register you with the hospital and will be destroyed after use. *
How did you find us? *
Check as many are applicable. Use the "other" box to write in additional details if desired.
Required
(1) Registration is not complete until you complete  payment and receive a confirmation email from our office.  (2) Payment can be made via Paypal to studyingpractice@gmail.com.  (3) $100 of the payment is  a nonrefundable deposit covering the extensive onboarding process.  (4) Onboarding also requires submitting to an online background check and sending in current medical records including TB, MMR, varicella, and a flu shot.  These are absolutely nonnegotiable.  (5) If all materials are received by 3 weeks before the start date, and all hospital requests for information are responded to promptly, then onboarding is guaranteed.   Otherwise, if onboarding not completed by the time of the observation, the $100 deposit will be retained.  (6) If you are not a citizen or permanent resident of the US, 6 weeks' lead time is needed. *
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