Print and Fax this form to 866.817.3561
OR copy & paste into email to                                                            




email ____________________________________________________________________


License # for CE documentation_________________________________________________

Phone (W) ______________________________(H) ________________________________



Registration Fee:  regular                    early (14 days prior)
1 person                        $149                       $139
2-4 people*                    $139*                     $129*
5+ people*                     $129*                     $119*
*Must be submitted together to receive group rate.

Amount charged______________________________ or enclosed____________________

_________Visa  ___________MC  ___________(3 digits on back of card)  _________Check

Card #________________________________________________Exp Date____________

Name on card_____________________________________________________________


CANCELLATION POLICY:  Refunds less a $25 processing fee will be given for cancellations that   are            
RECEIVED in writing, in our office, two weeks or more before the workshop date.  No refunds after this time.  
If a seminar cannot be held for reasons beyond the control of the sponsor (e.g. Acts of God) the registrant will
receive free admission to a rescheduled seminar or a full-value voucher, good for one year for a future
seminar. Non payment of full tuition may, at the sponsor’s option, result in cancellation of CE credits issued.

Make checks payable to:
Pamela Venné
Δ The Venné Group
16 Cheltenham Way
Dallas, TX  75230
Registration Form
Δ The Venné Group