Common Bond Institute

2019 T T Email Registration Form

Common Bond Institute (CBI)
Email Version

(copy and paste this text into an Email to complete and return)

8th Annual Intl. Conf. on Transgenerational Trauma

October 24-26, 2019 ~ Amman, JORDAN

CONTACT INFORMATION: (Include Email and Phone)

NAME: ____________________________________________________

ADDRESS: __________________________________________________

City_____________________ State__________________________

Zip Code_________ Country_____________________

PH ____________________ FAX_________________ CELL _______________

EMAIL_________________________ WEB _________________________

* [ ] I do NOT wish to be included in conference roster distributed to participants (address, phone, & Email only)

NOTE: Hotel rent by individual person rather than by the room
– Rooms & prices are per person for DOUBLE (shared) occupancy only.  Please indicate if you have a specific roommate.
For Single room add $25 per night (i.e. $75 for 3 nights).
* If you wish a double room and
a roommate is not listed we will first attempt to match you with a roommate. However if none is available the single room rate will apply.
– Additional Nights before or after the program are available when registering through Common Bond Institute. Contact us directly to book additional nights.
Full description of fees and what is included at:

Please indicate one preference for each option below.

Room: __Double __Single  /  __Male __Female  /  __Smoking __Non-smoking
(All meeting spaces are non-smoking)

Specific Roommate: __________________________________
Dates Of Attendance (required) Arrival & departure dates from Hotel:
Arrive: _____________ Depart: _____________

REGISTRATION FEE: (See types of registration and fees below)

1) 3 day/3 night CONFERENCE & HOTEL Package: October 24-26
Note: Conference Program begins the evening of Oct. 24th. For more nights at hotel please contact CBI.
Program and 3 nights room (24th, 25th, 26th) + breakfast and unlimited Internet
Prices are complete and include all taxes and service fees
This rate is per person for Double shared occupancy

Add $25 per night for single room ($75 for 3 nights)
[ ] $661 General Registration
[ ] $561 Full-time student*
(*proof of Full-Time Student status required at registration & check-in

2) CONFERENCE PROGRAMS ONLY: See description at conference web.
(Items listed under Conference/Hotel package NOT included under this option)
3day Conference Only – October 24-26:
[ ] $395 General Registration
[ ] $295 Full-time student*
(*proof of Full-Time Student status required at registration & check-in

3) FAREWELL DINNER PARTY: Oct. 26 – Includes all taxes and service fees
[ ] $ 28  (20 JD) 

SUMMARY OF DISCOUNTS available off full cost Conference Program Fee:
A) Early Registration: $25 off Regular Full Cost program fee by 9-24-19 (see above)
B) Presenters: 20% off Full Cost Program Fee (excludes accommodations)
C) Full-Time Students: $100 off Regular Full Cost program fee.
Proof of current full-time status required at registration and at on-site check-in.
D) Groups: $25 discount each off Regular Full Cost program fee only for groups of 3
or more registering together (at the same time).
E) Discount for generating additional Full Cost registrations: To assist our efforts
to subsidize attendance from economically impoverished societies, we offer a
$30 discount to individuals for each additional FULL COST Regular or Student
registration they generate (cannot be combined with group discount “D”).
Registrants should list your name & address on their form to qualify you for discount.
Rebates are given after all final payments are received.
Note: Contact Common Bond Institute for information on options D and E

– A minimum deposit of $300 must accompany this form.
– Full registration fee should be received by Sept. 24, 2019 to qualify for Early registration fee.
– Registration is not confirmed until payment is received, and hotel rooms and meals can not be reserved without advanced payment. Space in the conference and in the hotel is limited and on an as-available basis.
– For convenience, fees may be wired directly (contact CBI for wiring instructions).
Make checks or money orders (US$ only) payable to: COMMON BOND INSTITUTE

Conference / Hotel “Package”                    __________
(If Single Room add $25 per night):         __________
Additional ___ Room nights                     __________
“Conference ONLY” (no Hotel items)      __________
Farewell Dinner Party Sat. Oct. 26            __________

TOTAL CHARGES:                                     __________ *

Amt. Enclosed with registration:             __________

AMOUNT REMAINING DUE                  __________ *

* To pay by PayPal CLICK HERE – or see PayPal button on Registration Page at:

COMMENTS: _________________________________________

METHODS of PAYMENT (choose one):
NOTE: registration is NOT confirmed until payment is received (US$ only)

[ ] 1. On-line by PayPal (see above website): For Credit Card or bank withdraw
[ ] 2. By mail to Common Bond Institute: Check, Money Order, Cashiers Check
12170 S. Pine Ayr Drive, Climax, Mich. 49034 USA
Ph/Fax: 269-665-9393 Email:  Web:
* Note: Checks must be received by Oct. 12, 2019 for deposit and clearing.
After this please use PayPal or wire transfer
[ ] 3. By wire transfer (contact us for instructions)
[ ] 4. On-site at event (cash or travelers check only – US dollars or Jordanian JD only)

received in writing before 9-24-2019 will be charged a $100 administrative fee. No refunds can be made for cancellations thereafter.

Assignments: You may also assign your registration to someone else for participation at no charge (assignments must be made prior to the conference date in person and confirmed in writing directly to Common Bond Institute).
Disclaimer: Deposit indicates agreement to terms and releases Common Bond Institute from any responsibility, including but not limited to injury, damage, or loss suffered by anyone taking part in the conference program. Participants assume responsibility for all risks involved, expected or unexpected. Neither Common Bond Institute nor the conference organizers are involved in the travel business and, therefore cannot accept responsibility for any losses or damage to persons or property as a consequence of travel, lodgings, civil disturbance or any other person servicing this conference. Nor shall these parties be responsible for any extra expenses or losses arising from delays, cancellations, substitutions, or any act or omission whatever by airlines or other transportation companies.

Common Bond Institute
Steve Olweean, Conference Coordinator
12170 S. Pine Ayr Drive, Climax, MI 49034 USA
Ph/Fax: 1-269-665-9393 Email: Website: