BJE BEBE FEUERSTEIN SIMON INSTITUTE

2012 REGISTRATION FORM

Registrations received without payment will not be processed

Email or mail to:

Jillian Ben-Ezra jbenezra@bjela.org, BJE 6505 Wilshire Boulevard, Suite 300,

Los Angeles, CA 90048

or FAX to 323-761-8640. Attention Jillian Ben-Ezra

REGISTRATION FORMS MUST BE ACCOMPANIED BY PAYMENT IN FULL AS FOLLOWS:

 Registration: $ 75.00

Walk-in registrants who do not work in BJE Affiliated schools must pay $125.00 at the door in order to be admitted.