I am registering for

__ Seattle CDI -- in 2008 June 16 - 27; in 2009 June 15 - 26

Name:_________________________________________________

Address:_______________________________________________

            _______________________________________________

E-mail ___________________   [You must have e-mail, with a capacity to receive attachments in Word, and access to the web to participate in the program]

Fax______________________                           Day phone: _____________________

Parish:_____________________________         Diocese:_____________________________

Position:__________________________

__ Send information on CDI Trainers Certification Programs in Consultation Skills or Leadership

2008- 09 Tuition ...................................................$2000.00

$850 due with registration  

$800 due on the first day of the program 

$350 due March 1 before your second summer

I am enclosing a deposit of $______________         Checks Payable to "Robert A. Gallagher"

NOTE: Assumption of the program is that every one is registering for the whole program, i.e., both summers.  Deposit refunds: if cancellation is within 8 weeks of the event - no refund; if 10 weeks or more - $200 refund; if 12 weeks or more - $400. SPECIAL OFFER: Register by December 15 and take $200 off your fee (March 1 payment would be $150).

Housing -  You need to arrange for your own housing. See information on the web site

Send to: The Rev. Robert A. Gallagher, 1000 8th Ave; Apt 1-1209 ; Seattle , WA 98104

For more information contact: Robert Gallagher, 206-300-3700