Dragonfly Botanicals Workshop Registration & General Information
 

NAME ____________________________________________________________________

STREET ___________________________________________________________________

CITY/TOWN __________________________ STATE_____________ ZIP______________________

PHONE ______________________________ EMAIL _______________________________________

Emergency Contact: NAME: _________________________________ PHONE _________________

Please list the class you wish to register for, and the class fee below. Thank You.

Emergent Herbalist Apprenticeship Program Payment Options

Emergent Herbalist Apprenticeship Program Deposit of $150.00*
(circle if this is your choice)

OR

Emergent Herbalist Apprenticeship Program - Full Payment -
Sliding scale fee of $660.00 to $990.00
You select your apprenticeship payment fee & leave the rest to your karma.

E.H.A.P Total Payment you have chosen is $___________________*

*Your E.H.A.P student info package will be sent out once your deposit/total payment is received & cleared.

Please Note: Make all checks/money orders payable to Dragonfly Botanicals.
All deposits are non-refundable and non-transferable. There will be a $33.00 fee for bounced checks.

Mail form to: Dragonfly Botanicals, PO Box 102, Sanbornton, NH 03269
Questions? Call 603-934-3961 or email me at melissam@ttlc.net.

• Pre-Registration is encouraged as class space is limited and will fill quickly.
• A deposit is required to hold your place for the Apprenticeship Program and all deposits are non-transferable and non-refundable.
• All classes will be held regardless of weather so please dress appropriately.
• Directions to Dragonfly Botanicals Herbal Wisdom Center and further information will be sent to you upon receipt of your deposit.