Stop Emotional Eating, Binge Eating and Compulsive Overeating
The SolutionsWeigh

SolutionsWeigh Program Registration Form

(SolutionsWeigh does not share this information with anyone.)
Payment Options in Next Step.
* = required information

You are registering for which programs?

Walking Souls Program
EFT for Weight Loss
Solutions Monthly Lecture Series
Binge on Words Teleclass
Breaking Free Course
GETTING YOUR EATING IN ORDER 4 wk Phone Seminar / Teleclass Tuesdays May 18, 25, June 1 and 8th 2010 7pm to 8pm (EST) Fee: $125
Other
Method of Payment *	Online via PayPal Sending check by mail
Your Name *
Address *
Address 2
City *
State *
ZIP Code *
Email Address *
Telephone Home *
Telephone Work
Telephone Cell
Questions or Requests
Best Time to Contact You *
At Which Phone Number	Home Work Cell
Verification:


Note that fees must be paid in full before the beginning of the first class, thank you. No refunds for classes 10 days before start date. Payment Options in Next Step.