BASIC FAMILY MEDIATION TRAINING
Please complete information below and return by mail, email or fax to Glenn Cravez no later than November 20, 2017.
Date: December 2-6, 2017 Venue: Alaska Court System Snowden Building Training Center
820 W 4th Avenue Anchorage, Alaska 99501
1. Participants information
City:________________________ State:_________________ Postal/Zip code:__________
2. Cost: The cost of the training is $500 per person. Please make payment by check or credit card, as follows: Glenn Cravez - $250 and Terri Spigelmyer - $250. If paying by check, please make one check payable to Glenn Cravez and one check payable to Terri Spigelmyer, and then mail both checks to:
880 N St., Suite 203
Anchorage, AK 99501
If paying by credit card, Glenn Cravez will charge 50%, and Terri Spigelmyer will charge 50%.
Credit Card No.:____________________________
Address and Zip Code for Credit Card:______________________________________
If your training is being paid in part by the Court System, please let us know and please split the amount you are paying 50% to Glenn Cravez and 50% to Terri Spigelmyer.
Payment by Court System: $___________
Balance to be paid by participant: $________________, (to be paid 50% to Glenn Cravez and 50% to
You may return this form by mail, email firstname.lastname@example.org or fax: (907) 274-8201