Application Information and Information Request Form

Information and complete forms will be sent upon submission of the form below. To participate in the Renewal Program, candidates must complete the following requirements:

1) complete the extended application form;
2) submit two letters of recommendation.

Early application for each session is encouraged because there are only twenty-nine places. Persons can apply for one or both renewal sessions. Each session is planned to be both integral and complementary. An effort is made to achieve balance of age and experience among the participants.
Weekends and courses are open to non-residents for individual registration. Please contact Berakah directly for information about these options.

**For more information and application materials, please complete this form.**
Name
Community
Address
Address
City, State, &ZIP
Phone
FAX
E-Mail Address
Which sessions are you interested in?
Would you like to be on the Center Mailing list?

Please feel free to contact us:

BERAKAH
96 Fairview Road
Pittsfield, NH 03263-3817
Phone: (603)435-7271
FAX: (603)435-6670
E-mail: Berakah@AOL.com