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Application Form

Intimacy in the Gap 

A retreat for experienced students with Susan Mickel​

​

​De Burcht in Amsterdam, Henri Polaklaan 9

Sunday October 19th at 9:30 hrs until Saturday October 25th at 17.30 hrs, 2025

De Burcht in Amsterdam,  Henri Polaklaan 9

Fee € 895,-

The retreat is non-residential.  

Please make your own arrangements for accommodation and meals.

 

Applications will be taken on a first-come first-served basis. We reserve a place for you as soon as you confirm registration and have paid. Do so, also when you have to zoom with Susan. If necessary we will refund you fully. If applying for more than one person, please use a separate form for each person. 

Application

I, as the applicant, understand and agree that: Completing and returning this application in either physical or electronic form constitutes my agreement to all conditions following.I accept that my registration is complete only when my full fee has entered the identified bank account.Transfers in Euros. Refunds are possible before August 9th and later only if your place can be filled.There will be a € 75,- administration fee deduction to any refund made.

Payment: Transfer € 895,- to IBAN NL53TRIO0197721362

BIC TRIONL2U

Name: A.P. van de Ven

We will confirm your reserved place by email.

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