Writing the Soul’s Journey: An Autobiography Workshop in France June 26 - July 3, 2010 Application and Registration Name: __________________________________________________________________ Mailing address: __________________________________________________________ Telephone: ______________________________________________________________ Email: __________________________________________________________________ Contact person in case of emergency: _________________________________________ Please list the titles and approximate dates of any courses or workshops you have previously done with Marlene Schiwy. Have you previously done any autobiographical writing? Please comment. What brings you to this workshop at this time in your life, and what are your hopes and expectations for this week? Do you have any health issues we should be aware of? * If you are new to the instructor, a consultation hour is part of the application process ($120 p/h). To arrange a preliminary consultation, please contact Marlene Schiwy at 604-221-2372, or email Schiwy3@shaw.ca * Please note that this is a writing workshop, not a therapeutic setting. While the instructor is always present and attentive to individuals as well as the group, participants are responsible for themselves and their own work throughout their participation in this educational program. * Please sign and date below to indicate that you understand and agree to the above condition. Thank you. Marlene Schiwy and Yvonne Young Signature: __________________________________ Date: _______________________ Please send this completed application form and $100 deposit (payable to Marlene Schiwy) to: 104-2890 Point Grey Road Vancouver, B.C. Canada V6K 1A9

Writing the Soul’s Journey: An Autobiography Workshop in France

June 26 - July 3, 2010

Application and Registration

Name: __________________________________________________________________

Mailing address: __________________________________________________________

Telephone: ______________________________________________________________

Email: __________________________________________________________________

Contact person in case of emergency: _________________________________________

Please list the titles and approximate dates of any courses or workshops you have previously done with Marlene Schiwy.

Have you previously done any autobiographical writing? Please comment.

What brings you to this workshop at this time in your life, and what are your hopes and expectations for this week?

Do you have any health issues we should be aware of?

* If you are new to the instructor, a consultation hour is part of the application process ($120 p/h). To arrange a preliminary consultation, please contact Marlene Schiwy at 604-221-2372, or email Schiwy3@shaw.ca

* Please note that this is a writing workshop, not a therapeutic setting. While the instructor is always present and attentive to individuals as well as the group, participants are responsible for themselves and their own work throughout their participation in this educational program.

* Please sign and date below to indicate that you understand and agree to the above condition.

Thank you.

Marlene Schiwy and Yvonne Young

Signature: __________________________________ Date: _______________________

Please send this completed application form and $100 deposit (payable to Marlene Schiwy) to:

104-2890 Point Grey Road

Vancouver, B.C. Canada

V6K 1A9