A Clear View From the Mountain-Top...

Orgone Biophysical Research Lab

Ashland, Oregon, USA

Printable Registration Form

OBRL Greensprings Seminars



Please print out the following form, and fax or postal-mail it to OBRL at the address below. Alternatively, provide the same information by ordinary email.

Your Name ___________________________________________________________________

Spouse or Guests? ___________________________________________________________

Address _____________________________________________________________________

_____________________________________________________________________________

City/State/Zip ______________________________________________________________

Telephone/Fax _______________________________________________________________

E-mail __________________________________

Please identify the Title and Date of the Seminar Event you wish to attend:

_____________________________________________________________________________

How Many Persons will you be paying for?

_____ Laboratory Seminar on General Orgonomy, $600

_____ Partial Attendance to Lab Seminar, $150 per day (Please specify which days)

Total Registration Fees Due: _______________

Payment by Check/Money Order (send by postal mail) or Visa/Mastercard (send by postal mail, fax, or ordinary email). Make checks out to "James DeMeo". Credit Card payments will appear on your card under the name "Natural Energy Works" which is our mail-order charge account.

Visa/Mastercard
Number _______________________________________________________________

Expiration date ______________________ 3-Digit Security Code ________

Your Signature ________________________________________________________

If you are not the card-owner, also provide the full name, postal address and telephone number of the card-owner, as on record with the credit card company.

You can also register on-line:
CLICK HERE FOR ON-LINE REGISTRATION AND PAYMENT

Before registering, please review our Seminar Refund Policy.

Send this form or similar information, with payment to:

James DeMeo, Ph.D.
Orgone Biophysical Research Laboratory, Inc.

Greensprings Center, PO Box 1148
Ashland, Oregon 97520 USA
Phone/Fax: (541) 552-0118
E-mail to: info(at)orgonelab.org
(Click or copy into your email program and insert the "@" symbol)

More information on OBRL Seminars can be found at:
http://www.orgonelab.org/events.htm