International Authentic Movement Retreat – Application Form

June 29th - July 5th Tuscany, Italy; with Tina Stromsted, Ph.D., Jungian analyst and Dance therapist; Assisted by Margareta Neuberger, MA

Application Date
MM slash DD slash YYYY
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Telephone*
Email*
Have you been to one of Tina's Authentic Movement Retreats in Tuscany in the past few years?*
- Yes, I am a returning participant
- No, this is my first time

For Newcomers Only