Name(s): ______________________________________________________________________________
Mailing address: ________________________________________________________________________
City and State: _______________________________________________________Zip Code___________
Phone: ______________________________ Email: __________________________________________
In case of emergency contact: ________________________________phone:________________________
#1 Pre-convention Workshop: “The Rings of Oden, New Technology for Quantum Healing” with Aaron & Sue Singleton- Monday June 13
Name(s):___________________________________ASD Member: $65________Non-members: $80_________
#2 Pre-convention Workshop: “Building the Light Body” Zacciah Blackburn- Monday June 13
Name(s):___________________________________ASD Member: $65________Non-members: $80_________
#3 Pre-convention Workshop: “Infinite Levels of Water” with Aime Trent Millet Monday June 13
Name(s):___________________________________ASD Member: $65________Non-members: $80_________
#4 Pre-convention Workshop: “Psychic Self-Defense” Elivia Melodey Monday, June 13
Name(s):___________________________________ASD Member: $65________Non-members: $80_________
#5 Pre-convention Workshop: “Creating Your Personal Canvas Labyrinth” Sandy Isgro: Monday & Tuesday 9:00-5:00 p.m. ****Class size is limited to 12, please register early***** lab fee for labyrinth you make and take home
Name(s):__________________________ASD Member: $110(+$45 lab fee) ________Non-members: $125(+$45 lab fee) __________
#6 Pre-convention Workshop-“Using Colortherapy in Medical Radiesthesia”Alicja Aratyn: Tuesday June 14
Name(s):___________________________________ASD Member: $65________Non-members: $80_________
#7 Pre-convention Workshop- “Shamanism and Dowsing: Ancient Disciplines to Discern the Mystery” Sandee Mac Tuesday
Name(s):___________________________________ASD Member: $65________Non-members: $80_________
#8 Pre-convention Basic Dowsing School – Marty Cain and Rodney Berger, Co-directors “Dowsing- A Key to the Infinite Mystery” **Registration Deadline is Friday, May 20, 2005
Name(s):___________________________________ $110.00(includes tool kit) Basic Dowsing School Tuesday & Wednesday
#9 Pre-convention Expanded Dowsing School – Walter Woods, Director (Prerequisite: Basic Dowsing School) Tuesday & Wednesday
Name(s):_______________________________ASD Member: $110_________________Non-members: $125______________
Pre-Convention Workshops and Schools Subtotals:
$_____________
Specialized Schools: Lab fees are for student materials. See Descriptions for Pre-requisites. Everyone welcome to attend.
Name(s): __________________________________________________________________________
_______ #10 Map Dowsing Leroy Bull (Tuesday) $75
($65 + $10 lab fee)
______ #11 Intermediate and advanced levels
Dowsing School: Susan Collins (Wednesday) $75 ($65 + $10 lab fee)
______ #12 Dowsing and Well Drilling:
Howard
“Porky” and Bess Cutter (Wednesday) $65
______ NEW!
#25 Esoteric Tuning:
Don Taylor (Wednesday) $75/$65
+ $20 materials fee
Specialized Schools Subtotals: $___________
#13 Post-convention Workshop-“The Secret of the Rod of God” with Keynote Speaker William Henry Sunday June 19, 2:00 pm - 5:00 pm and Monday June 20, 9:00 am to 5:00 pm
Name(s) __________________________________ ASD Members: $110.00________Non-members: $125.00 _______
#14 Post-convention Workshop: 'Stone Age Farming' with Alana Moore Workshop Sunday June 19th 2-5pm and Monday June 20, 9:00 am to 5:00 pm
Name(s) __________________________________ ASD Members: $110.00_______ Non-members: $125.00________
#15 Post-convention Workshop: “Turning Dowsing into a practical Health Profession” with David Alan Slater Sunday June 19, 2:00 pm - 5:00 pm and Monday June 20, 9:00 am to 5:00 pm
Name(s) ___________________________________ASD Members: $110.00________Non-members: $125.00_______
#16 Post-convention Workshop “Use of the Virtual Cone Pendulum with Marty Cain Sunday June 19, 2:00 pm - 5:00 pm and Monday June 20, 9:00 am to 5:00 pm
Name(s) __________________________________ ASD Members: $110.00 ________ Non-members: $125.00 _______
#17 Post-convention Workshop “Creating with the Heavens: A Guide to Unstoppable Success” with Jean Slatter Sunday June 19, 2:00 pm - 5:00 pm
Name(s) ___________________________________ASD Members: $45.00_______ Non-members: $60.00_______
#18 Post-convention Workshop “Working with the energy of the Soul” with Pat Dornik Sunday June 19, 2:00 pm - 5:00 pm
Name(s) ___________________________________ASD Members: $45.00_______ Non-members: $60.00_____
#19 Post-convention Workshop “Programming Crystal Consciousness” with Frank Jordan Sunday June 19, 2:00 pm - 5:00 pm
Name(s) ___________________________________ASD Members: $45.00_______ Non-members: $60.00_____
#20 Post-convention Workshop “Practical Spiritual Table-Tipping” with Dr. Susan Shumsky: Monday June 20
Name(s) ___________________________________ASD Members: $65.00_______ Non-members: $80.00_____
#21 Post-convention Workshop “Soul Journeys Workshop" with Ellie Drew: Monday June 20
Name(s) ___________________________________ASD Members: $65.00_______ Non-members: $80.00_____
#22 Post-convention Workshop “Change your energy –Change your Life” with Dr. Constant (Connie) Madon: Monday June 20
Name(s) ___________________________________ASD Members: $65.00________ Non-members: $80.00_______
#23 Post-convention Workshop “Quantum Divination Workshop” with Loren G. Tindall: Monday June 20
Name(s) ___________________________________ASD Members: $65.00________ Non-members: $80.00_______
#24 Post-convention Workshop "Shamanism Workshop" with John Kelly: Monday June 20
Name(s) ___________________________________ASD Members: $65.00________ Non-members: $80.00_______
Post Convention Schools Subtotals: $ ______________
Reunion Luncheon: Free to members who joined ASD between 1961 & 1988; pre-registration is required (limited to 30 people). The focus of this Luncheon is “Share your memories of Roland “Rollie” Moore & Dwin Gordon, Master Dowsers” Saturday June 18 – School Cafeteria, private dining room.
Name(s) ________________________________________________________________
Name(s)_________________________________________________________________________________
Member Fees Prior to May 14, 2005
Non-Member Fees Prior to May 14, 2005
_____$140.00 individual (4 days) ____$210.00 families
(4 days) _____ $185.00 individual (4 days) ____$280.00 families
(4 days)
_____$ 50.00 per day circle day(s): Thurs., Fri., Sat.,
Sun.
_____$ 70.00 per day, circle day(s): Thurs., Fri., Sat., Sun.
_____$ 70.00 Member student (with I.D.) 4 days
_____$92.50 Non-member student (with I.D.) 4 days
_____$ 45.00 Speaker spouse/speaker asst. (4 days)
Member Fees After May 14, 2005
Non-Member Fees After May 14, 2005
_____$165.00 individual, 4 days
_____$220.00 individual, 4 days
_____$250.00 families, 4 days
_____$330.00 families, 4 days
_____$ 50.00 per day circle day(s): Thurs., Fri., Sat.
Sun _____$ 70.00 per day, circle day(s):
Thurs., Fri., Sat., Sun.
_____$82.50 Member student (with I.D.) 4 days
_____$110.00 Non-member student (with I.D.) 4 days
Membership: Membership Fees (if applicable
at this time)
New ASD Membership ___ or Renewal
____ CIRCLE BELOW:
Individual: $35.00 | Junior (under 18): $18.00 | Family: $53.00 |
Non US: $41.00 | Non US Family: $58.00 | Supporting $88 | Contributing $175
SUBTOTALS:
(1) Pre-Convention Workshops and Schools:
$________ Specialized Schools: $______ Post Convention
Schools: $ _______
(2) Convention Fees: $__________
(3) Membership fees (if applicable) $ _________
Total Fees: $___________ (US FUNDS ONLY)
Total amount enclosed (check or money order) OR payment by Credit Card: Visa _____ MasterCard _____
Name on card: ________________________________________________________________________
Card Number _______________________________________________ Expiration _________________
CANCELLATION POLICY – If unable to attend, ASD will refund convention/school fees less a 15% processing fee.
NOTE: ALL EVENTS ARE SCHEDULED TO BE HELD AT
LYNDON STATE COLLEGE. PLEASE REGISTER WITH THE COLLEGE FOR ROOMS
AND MEALS TO COINCIDE WITH THE EVENTS THAT YOU PLAN TO ATTEND.
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