Online Secure Payment Form
World Congress on Psychology and Spirituality, India 2008 

  Submit Only one person per form.
 
First Name
   Last Name
Institutional Affiliation
Role at above
 (e.g., faculty, administrator, student, clinician, etc. )
  If you are paying by credit card, the address below must be your billing address for the credit card listed. You may include other addresses or information in the notes field below.
Address
 (as on credit card)
2nd Addr. Line
City
   State   Zip/PC
Country
 (ONLY IF NOT IN U.S.)
Phone
Email Address
 (REQUIRED for confirmation)
 
Discounts: CURRENT MEMBERS of ATP, AHP or FULL TIME STUDENTS (with ID) receive a discount off of the conference or single day prices listed below. (CLICK HERE TO JOIN ATP NOW AND SAVE )
Main Conference Registration: (choose 1)
  $590 - VIP Registration with Reception Included
  $490 - Regular Non-Member Registration
  $440 - Regular  Member Registration
  $390 - Student (full-time with ID)
  $340 - Attendees from emergent economy countries
  $300 - Special Needs Registration (must be approved by stuart@jps.net)
Pre-Congress Workshop: (choose 1)
  Pre-Congress Vedic Fire Ritual (Yagya) at Surya Farms Country Estate, includes bus transfers and catered luncheon Morning, January 5, 2008
  $110 - Sponsor level registion
  $85 - Regular registration
Post Congress Workshops:
  $130 - Nada Healing and Empowerment Workshop
  $145 - Advanced Beeja Mantra and Drishti Yoga Course (Nada attendance required)
Other events:
  $130 - January 4th Holotropic Workshop 
  $180 - January 3th and 4th Holotropic Workshop 
   
 
I will mail a check for the total amount made out  to: ATP-India Conference
and send it to Stuart Sovatsky, 6225 Doremus Avenue, Richmond, CA, 94805 USA
Notes  

"The following are the details for bank transfer payment for REGISTRATION ONLY"

ACCOUNT NUMBER- World Congress PS-2008: 002105008159

Branch: ICICI Bank DLF Branch, Gurgaon

Swift Code for outward remittance to India ICICI bank- ICICINBB007

Intermediary bank - JP Morgan Chase

Swift Address/FED ABA (USD) :

CHASUS33XXX/FED ABA 021000021

When you click submit below, it will send this form to the CO using a secure server

  
REFUND POLICY: Requests to cancel registrations and obtain a refund can be made until August 1, 2007, less a $35 administrative charge and thereafter until October 1, 2007 less a $50 administrative charge until December 1, 2007. After December 1, 2007, no refunds will be given for cancellations.