Fillable CHECK Registration Form (Triadex Services)

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CHECK Registration Form (Triadex Services)

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Country of origin: US
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CHECK Registration Form
NOTE – If you are paying your tuition in full with a credit card, please register and pay online. Our online
system is fast, easy and available 24 hours a day. Visit www.traumahealing.org, find your training on the Training
and Event Schedule, and click on the “Register Now” button. Our online registration system meets the highest
standards of credit card payment security.
Name ___ ______________________________________________________________
Address ___________________________City ___________________________
Province or State ___________________ Postal Code _____________________
Country __________________________ Phone _________________________
Student Account E-mail __________________________________________________
Training Level (i.e. Beg II) ______________________Dates ___________________
Cohort Location (city/state)**____________________________________________
Tuition Amount Due/Enclosed $_________________
To receive the Early Registration price, your check must be postmarked by the early registration deadline
Payment Details:
Check # ________ or Money Order made payable to SE Trauma Institute (enclosed)
Student Signature ________________________________________ Date __________
Return to:
Somatic Experiencing Trauma Institute
5303 Spine Rd, Suite 204, Boulder, CO 80301
OR SCAN TO: Registration@traumahealing.org
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CHECK Registration Form (Triadex Services)

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Completed 22 December 2021

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