|
Name:____________________________________________
Address:__________________________________________
Address:__________________________________________
City:______________________________State:__________
Zip/Code:____________ Country:____________________
Phone:(Day)_______________________________________
(Evening)_________________________________________
E-Mail:___________________________________________
 Please send me notices via E-Mail.
|
TAX-DEDUCTIBLE DONATION
Donation
$______
MEMBERSHIP LEVELS
|
Lifetime Member
$1,000 and up
Supporting Member
$100-$999/yr.
Associate Member $35-$99/yr.
Student Member $20/yr
|
$______
$______
$______
$______
|
PROGRAM REGISTRATION
| Date . . . . Event/Title
________________________________
________________________________
________________________________
Membership Discount
(15% on all programs held at
the Center)
TOTAL ENCLOSED . . . . . . . .
|
Tuition
$______
$______
$______
-$______
$______
|
Check enclosed
Please charge my: ____VISA
____MC ____ AmEx
Card Number:
________________________________________
Expiration Date _________
Security code
_______ (3-4 digit # on back of
card)
Signature _____________________________________
|
|
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Become a Member of the Center Today!
Help us continue to anchor this light center and become our
partner in building a positive future for our nation and the world. Becoming a member at
whatever level you can afford or making a tax-deductible contribution is deeply appreciated and urgently needed to help fulfill
our mission. The Center
is a non-profit, tax-exempt organization and we welcome your support.
MEMBERSHIP CATEGORIES & BENEFITS:
Lifetime
Member: $1,000 and up. Benefits: Free
attendance at all Center
programs for life; invitations to special
receptions and events; autographed copy of
Spiritual Politics; free
subscription to our e-newsletter,
Soul Light.
Supporting Member: $100-$999/yr. Benefits: 15% discount on Center
programs; copy of
Spiritual Politics (new
members only); free subscription to our e-newsletter,
Soul Light.
Associate Member: $35-$99/yr. Benefits: 15% discount on Center
programs; free subscription to our e-newsletter,
Soul Light.
Student Member: $20/yr. Benefits: 15% discount on Center
programs, free subscription to our e-newsletter,
Soul Light.
PROGRAM REGISTRATION: To ensure your
place, pre-registration is recommended
for all programs. To register by mail: send this form with check for full
payment. Walk-in registration: call 415-472-9540 to make sure space is still
available and arrive early. Cancellations: you will be notified if a program
is cancelled. Refunds** are given when: (1) a program is cancelled, or (2)
when you notify The Center seven days prior to the program you have to
cancel. You may receive full credit for another program or a cash refund
less a $10 processing fee. The fee will be issued if you cancel less than
seven days prior to the program date and no refunds will be given for
cancellations less than 48 hours before a program.
Please mail this form with your check (Payable
to The Center for Visionary Leadership) to:
The Center for Visionary Leadership
6423 Hermsley Road
Charlotte, NC 28278
East Coast
Phone: 704-583-0080
West Coast Phone: 415-472-2540
E-mail: cvldc@visionarylead.org
Web site:
http://www.visionarylead.org
Write or call for a free brochure.
*Some
restrictions may apply. Discount cannot be applied to conferences or
off-site retreats.
**Excludes
special programs- special instructions will be
given. See specific program for additional information. |
THE
CENTER
FOR
VISIONARY
LEADERSHIP