Application: (Renee, Add the Word OASIS Here & Autumn & 2006 Rather Than 06) s1

OASIS RETREAT Application – OASIS by the Sea – 46 Soundview Avenue, Milford, CT

Friday, November 13 9:30 AM – 3:30 PM EST

Please fill in this form and return it via o email: [email protected] with copy to [email protected] o or mail: Renee O’Connell * OASIS * 3 Old Country Road * Oxford, CT 06478

Name ______email ______

Address ______tel ______cell ______fax ______

Profession ______your website ______

1. How did you know about this Retreat? and/or How long have you known Millie – from where?

2. Why are you interested in the OASIS Retreat? – What attracts you to OASIS right now?

3. Are you taking the Retreat primarily to: a) benefit yourself b) use with others c) both d) not sure yet

4. What do you especially want for you on this OASIS Retreat Day?

200 Orchard Street, Suite 301 New Haven, CT 06511 203-789-2191 milliegrenough.com [email protected] Extend your Retreat Day with Happy Hour & Supper at Mercy: ______Celebrate/schmooze with Millie and her OASIS Grads - $25

CCEUs ______For ICF Coaches: 3 Core Competencies, 3 Resource Development - $20 ______For Counselors, LMFTs: 6 CEUs - $20

OASIS books, CD, DVD – buy that day at a special discount.

Retreat $70 Schmooze & Supper $25 CCEUs $20 Day 2 – Training $550

____ Yes, I want to apply for the OASIS Retreat being offered. ____ Yes, I want to apply for Day 2 of the OASIS Training. ____ Enclosed is my check made out to OASIS. ____ I prefer to pay by credit card or cash. Please contact me.

Name (printed) ______

Signed ______

Date ______

Any questions, feel free to contact Training Director Renee O’Connell at 203-982-9251 or [email protected] Thank you!

200 Orchard Street, Suite 301 New Haven, CT 06511 203-789-2191 milliegrenough.com [email protected]