Quantum-Touch Basic Workshop Registration

Once you have submitted your Registration form, you will receive a confirmation page with a link to the Payment Options page. There, you can either pay online via credit card or PayPal, or if you prefer, you can find instructions for paying by check.

I am also providing a link here for the Payment Options page in case you wish to return to it for any reason later on. Do keep in mind that your registration is not complete until I have received your payment.

If registering through this form poses a problem for you, you can call (201-790-5604) or e-mail Jocelyn to obtain a hardcopy Registration Form.

Name *
E-mail Address *
Date & Location *
Address (1) *
Address (2)
City or Town *
State *
Zip Code *
Telephone - Home *
Telephone - Work
Telephone - Cell
Have you taken a previous LIVE (not video) Q-T Basic Workshop? *	This is my first Q-T Basic Workshop I have taken a previous Q-T Basic Workshop (Copy of previous Certificate of Completion required.)
Form of Payment *	I am paying online. I am paying with a check.
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IMPORTANT: Please note that you will not be considered fully registered until we have received your deposit. We will register you provisionally for three days once we receive your registration form; if we have not received your check by then, you will be moved to our waiting list until we receive your check.