Workshop Registration

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Another Empowering Values Realization Workshop
Is Scheduled for 4 nights and 5 days
July 2nd – July 6th 2017
It will certainly be SOLD OUT just like the
Simon workshop of 2014

 At the wonderful Kirkridge Conference Center, Bangor, Pennsylvania.


To see more detailed information on the workshop before registering
Select “Workshop Flyer” on the Simon Workshop 2017 menu above.

This is the registration page for the 2017 Simon Workshop. Please complete all fields on the form.

The fee for the workshop is $665 for one person and $1200 for two people registering together. You will need information such as emergency contact's name, phone number, and any special needs you may have. If you are registering with someone you will need this information for both registrants. You may also list a roommate preference. It is highly recommended that you have this information available before you begin the registration process.

Payment may be made by credit card, PayPal or check. If paying by check please click the appropriate box and mail a check to:
Dale Bennett
Simon Workshop Treasurer

If you believe you entered something incorrectly or would like to make changes to the information you input, please send an email to

You may find it more convenient to use the "tab" key to navigate from field to field.

Scrolling is also permitted while in the registration form.

If you do not receive a registration confirmation email within 5 days please email me, Dale,

Finally, after submitting this registration form you will be taken to the Payments Page where you may pay your deposit. Because the workshop is expected to sell out a deposit is required to guarantee your reservation.