Registration for the PAS-Workshop

Please register with this form, if you ONLY want to participate in the PAS-Workshop. Otherwise please use the main registration form for the Congress in Rome. There you can also select the PAS-Workshop.

Mr.Ms.Mrs.
Title
First Name *
Last Name *
Street / No. *
ZIP-Code *
City *
State/Country *
Phone *	International Code          ( e.g. 0043 for Austria )
	Complete Number*
E-Mail *
Native Language*	evtl. 1. Foreign Language:                                                                                      evtl. 2. Foreign Language:

Workshop	I participate in the PAS-Workshop during the Congress:
	PAS-Workshop for Doctors and Persons in the Counceling- & Healing-Service:                                                      Sat. 9.10., 15:00 - 18:30 Uhr           Professional  Category: Please select...DoctorpsychologistPriestWorker in the Healing-ServiceWorker in the Counceling-ServiceOther*                               (if 'Other' please write here: )
Costs for Workshop: 20.- Euro

Fields with * must be filled out.