REGISTRATION FORM for Visioning A Unified God-Image for a New World
by Jean Benedict Raffa, Ed.D.

Friday, February 12, 2010  7:00 p.m   Lecture
The Unitarian Universalist Church
3975 Fruitville Rd., Sarasota
Saturday, February 13, 2010  10:00 a.m. to 3:00 p.m   Workshop
The Unitarian Universalist Church
3975 Fruitville Rd., Sarasota

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DATE____________
NAME:___________________________TEL:________________ E-MAIL:_________________________
ADDRESS:_________________________________________________________________
CITY:__________________________STATE:______________________ZIP:________________

COST:

Workshop
______$30 members C.G. Jung Society of Sarasota
______$35 non-members
______$10 students

Amount enclosed $_____________   (Make check payable to C.G. Jung Society of Sarasota)

Mail registration form and check to:

The C.G. Jung Society of Sarasota
P. O. Box 50611
Sarasota, FL 34232