Basic Workshop Registration
 

Once you have completed this registration form, click "Submit," and you will receive confirmation and instructions for payment.

 

If for some reason registering through this form poses a problem for you, you can call Anto Kizirian at (818) 648-8999 to register over the phone.

Full Name
E-mail Address
Date & Location
Address (1)
Address (2)
City or Town
State
Zip Code
Telephone - Home
Telephone - Cell
Have you taken a Live Q-T Basic Workshop previously? 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 by mailing a check.

IMPORTANT: Please note that you will not be considered fully registered until we have received your payment. If you are paying by check, we will register you provisionally for four days once we receive your registration form; if we do not receive your check by then, you will be moved to our waiting list until we receive your check.  We will never share your individual personal information.