Registration Form - Crazy Tiger Institute

CRAZY TIGER INSTITUTE
For the Cultivation of Living Systemic Understanding & Design

REGISTRATION FORM

Course: SYSTEMIC UNDERSTANDING: Bateson & Maturana
Quarter: Spring 2008

Registrant (please print or type):

Name:_________________________________________________________________________

Street Address:_______________________________________________________________

City, State, & Zip:___________________________________________________________

Country:______________________________________________________________________

Business Telephone:___________________________________________________________

Home Telephone:_______________________________________________________________

Email:________________________________________________________________________

_____	This is a new address and/or telephone number.
_____	I cannot participate this quarter, but please keep me informed of future activities.
_____	On the back of this form, I have provided a name & address of someone who I think might appreciate hearing about your Institute events.
_____	On the back of this form, I have listed courses or workshops I wish you would offer.
_____	I would be interested in one-on-one mentoring. Call me to schedule an appointment.

Please enclose a check for $1450, payable to Rodney Donaldson, and send to:

Dr. Rodney E. Donaldson
Crazy Tiger Institute
2404 35th Ave. W
Seattle, WA 98199

Registration Deadline: Wednesday, April 2, 2008
(Late registration $150 extra) (No refunds after registration deadline.)