Nikelle Rosier, MSW, LICSW Therapist and Educator

Registration Form


Wedding date(if known):
Your Name:
Street Address:
City:
State:
Zip code:
Phone number:
Your email:
Partner's Name:
Street Address:
City:
State:
Zip code:
Phone number:
Your email:
How did you hear about The Premarital Workshop?

To register, send form and 50.00 deposit * per couple, check or money order made out to Nikelle Rosier & Assoc.

Send deposit:

444 NE Ravenna Blvd
Suite 301
Seattle, WA 98115

Receipt will be provided by email. Once we receive both the registration form and deposit, your registration will be complete. We will follow-up by sending an e-mail containing our Orientation Packet which includes all information in preparation for the workshop, including directions to the workshop location and instructions for taking an online relationship inventory.

*The remainder balance will be due at the beginning of the first class. The deposit is non-refundable.