GETTING THE LOVE YOU WANT Workshop for Couples
REGISTRATION FORM

This is NOT an online form. PRINT this form and fax it to (480) 969-5703
 or mail it with check/money order or credit card information for $700 to:
Ruth Huttner, MA, LPC
1405 N. Dobson Rd., Suite 1
Chandler, AZ 85224-5604  

 
 

IMPORTANT INFORMATION
 

FEES
The cost of the workshop (which includes two workbooks, handouts, coffee, tea, and snacks) is $700 per couple. Insurance may cover a portion of the workshop fee. Hotel accommodations and meals are NOT included in the fee.
   
CANCELLATION POLICY
A $100 administrative fee will be charged for cancellations made 14 days or less before the workshop. In case of illness or emergency, your fee can be applied to a workshop within the next 6 months.
   

WORKSHOP HOURS
Friday 7PM - 10PM
Saturday 9AM - 7PM
Sunday 9AM - 6PM

    
LOCATION
To be determined.

While it is not required, you are encouraged to stay at the hotel for the weekend.  This enhances the workshop experience by allowing you to focus completely on each other.

Please make plans to attend the entire weekend. It is important not to allow family or business obligations to interrupt you once you begin the workshop. Dress to be comfortable.

 

 

 

 

 

 

 

 

Name: 

Phone: 

Day-

Eve.-

Email:
 

Name: 

Phone: 

Day-

Eve.- 

Email:

 

Mailing 
 Address: 

City/ST: 

Zip: 

 

How did you 
hear about us? 

Date of Workshop: 

  See Schedule
 
 

Form of Payment:

Check

 
(Make checks payable to: Ruth Huttner)
 

Credit Card #: 

Exp. Date: 

Name on card: 

Card billing address: 

Signature: 

For more information call Ruth Huttner at (480) 899-5800
  

PLEASE PRINT AND MAIL OR FAX THIS FORM 
ALONG WITH PAYMENT.
We recommend printing a copy of this form for your records.


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