Application Form
Name_________________________________________ Profession/Degree_________________
Address_______________________________________________________________________
City, State, Zip_________________________________________________________________
Phone: (______) _________________________ Fax: (______) _________________________
Of course I'll join the Tomkins Institute so I may receive the Bulletin of the Tomkins Institute and discounts for Institute activities. $45 _______
Fee for Meeting: US$_______ Friday Seminar ___ Yes ___ No Fee: US$________
PLEASE NOTE: We will attempt to seat all registrants in the afternoon seminar of their choice. Please list your first and second choices for each afternoon's seminar by placing the numbers "1" or "2" on the appropriate line.
Saturday: __ Kelly __ Hill __ Deppe __ Wright __ Hite Sunday: __ Kelly __ Ryan __ Moore __ Klein __ Desmond/Pfrommer
Audiotapes of Tomkins Institute Annual Meetings are available in boxed sets of 12 cassettes. $190 for non-members, $160 for SSTI Members (shipping and handling included.) For 1996, only the Hill and the Moore afternoon workshops will be taped.
__ I can't attend this year. Please send audio cassettes of the 1996 conference.
__ Send me the tapes of the 1993 meeting "Toward a New Psychotherapy" in which you defined so many of these concepts.
__ I missed the 1994 conference "The Experience and Expression of Anger." Please send the album.
__ The 1995 conference "Affect, Script, and Psychotherapy" sounds like a good primer for this year's meeting. Please send it.
Total amount: Meeting US$_____ + Tapes US$_____ + Membership US$_____ = US$ ______
Please charge my VISA MASTERCARD
Account No. ____________________________________ Exp. Date: ____________________
(Signature) ____________________________________________________________________
Questions about the meeting, travel, or lodging? Call Shelanski Associates at 1-800-669-0096. Group rates have been arranged at several fine Philadelphia Hotels.
Make check payable to Tomkins Institute.
Send payment and completed application to: Shelanski Associates, 437 Chestnut Street (Suite 1017), Philadelphia, PA 19106. Credit card purchases will be handled by Shelanski Associates, whose name will appear on your receipt. Fax number for Shelanski Associates is 215-928-9593.
Comments from previous attendees:
Excellent. Has provided me with a different perspective for viewing human behavior.
Topics continue to be at a level of basic relevance. Filling, not fluff. Well done!
Recommended to several colleagues and they were excited about what they learned.
Exciting, profound, fundamental, transformative, clarifying!
Thank you for presenting a spiritual perspective to the therapeutic community. We need to feel comfortable providing this to our patients.
Affect theory continues to excite me. Excellent program. Good variety of presenters.
This conference scored a perfect bullseye!
