This is a printable form that can be mailed or faxed to us.
For on-line service, click on Request for information".
Workshop Registration Form
Energizing the Leader Within
Inspirational Leadership in the Holy Land
Name _______________________________Title_______________________________
Organization_____________________________________________________________
Street Address ___________________________________________________________
City___________________________________________State__________Zip________
Home Phone________________Bus. Phone________________Email:_______________
Passport info: (Passport not necessary for registration, although you should apply soon).
Full legal name on passport_________________________________________________
Birthdate_______________________Birthplace_________________________________
Citizenship_____________Passport No.___________Issue Date________Exp.Date____
Deposit:
Enclosed is my check in the amount of $____________($1000 per person, minimum) as a deposit toward the "Energizing the Leader Within"; workshop. (All checks are to be made payable to Sources and mailed to: RD#4 Box 160E, Ligonier, PA 15658.
The full balance amount is due October 15, 2000. There is a cancellation fee of $1000 in the unfortunate event that you should cancel after these dates. You may substitute another in your place should you be unable to attend.
Costs:
$ 5,375.00* per person, includes Coach Class airfare., ground transportation in Israel, lodging and meals for 10 nights.(Includes the first night in Eilat, the 8 days of the workshop, and the night in Tel Aviv before departure for home on December 12, 2000 from Tel Aviv.
$ 4,775.00* per person for each additional registrant from the same organization
*Deduct $1250.00 if arranging own air travel
*Add $1350.00 if you prefer to travel Business Class.
Fianl Travel Dates and Locations: Subject to further confirmation
December 2, 2000 from Newark, NJ/Tel Aviv, Winter 2000
December 3, 2000 from Sde Dov/Eilat
Return December 12, 2000 fromTel Aviv/Newark, NJ
(Departure date extension available through Abrams Travel, Inc.).
To register or inquire about the workshop, contact:
Gerald Pavloff
Sources for Human Resource Management
RD#4, Box 160E
Ligonier, PA 15658
(724) 593-5651 phone
(724)593-5628 fax
Email: [email protected]
Or
Ury Gluskinos, Ph.d.
Pan Center for Management Consultation
42A Golomb St.,
Givataim, Israel 53464
011- 972-3-5713305 phone
011-972-3-5713306 fax
email: [email protected]