Searching For Courtship Workshop Leader Application

---

This form cannot be submitted online. You must print it, fill it out, and then mail or fax it to us.

---

 

Searching for Courtship Workshop Leader Application and Order Form

Name:_____________________________ Professional/Academic title:_______________

Address: __________________________________________________________________________

Phone/fax:_________________________ Email:_______________________________________

Occupation: ________________________________________________________________________

Name of practice or medical affiliation (if applicable)
_______________________________________________________________________________________

 

Briefly list credentials and degrees: _______________________________________________

Please describe how you intend to conduct your workshops . For instance: in your counseling practice, as a sponsored educational class, for a singles event, or informally with a group of single women?
_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_____________________________________________________________________________________

 

I present this information as accurate and hereby apply to be an Athena Workshop Leader

Date__________ Signature ___________________________________

Athena Institute welcomes all applicants interested in becoming a Workshop Leader using the Searching for Courtship materials. Athena does reserve the right to review and reject Workshop Leader applicants it deems unqualified.

Place your order:
Workshop leader kit @ $229.00_______ Mc/Visa/Discover
Shipping charges @ $20.00 ________ ______- ________ - _______- ________ Exp ______
or Fedex charge @ $45.00 ________ Signature: __________________________________
Sales tax (pa only) add 6% $_______
Total enclosed $________ Money orders or Checks to "Athena Institute"

Shipping address if different from above: __________________________________________________________
(must match credit card billing address)

Please contact Athena Institute with any questions via phone : 610-827-2200
Email: athena@athenainstitute.com
Fax or mail this form with your payment to:
Athena Institute, 1211 Braefield Rd., Chester Springs, PA 19425 Fax: 610-827-2124
Or if you prefer, you can phone in your order (610-827-2200) or you can fax or mail it using the order form below. You can also e-mail us to receive free printed info (please state in your message which products interest you, and provide a mailing address).

We Accept Visa/MC Credit Card Orders, U.S. checks or money orders.
(*checks require 14 extra days for verification of funds)