The Gathering of EcoCulture
August 2-5, 2001
Northern California

REGISTRATION FORM

c I accept the invitation to join The Gathering of EcoCulture

Name:__________________________________________
Address:________________________________________
City:__________________State:__________________Zip:_________________

Home Phone:_______________Office Phone:____________________Fax:______________E-Mail_________________

FEES: $160.00 Per Person in a double occupancy room (includes 2 nights lodging, meals and program)
$180.00 Per Person in a single occupancy room (includes 2 nights lodging, meals and program)

A limited number of scholarships are available, please call for information.

Payment Method:Please makes check/money order payable to:

The Gathering for Ecoculture/Tides Center
58 Cloudview Road
Sausalito, CA 94965


c Check

c Money Order

Cancellation Policy: Before July 1, 2001: 50% refundable

After July 1, 2001: No refund

Special dietary needs:____________________________________

What form of transportation will you use to get here?______________________

 Thank you! You will receive a confirmation in the mail which will include a daily schedule, driving instructions and a list of what to bring.