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Form for Payment by Check

Kindly print this page, complete the form, enclose your check, and return to:

Claudia Rose

PO Box 873, Enosburg Falls VT 05450


Confirmation & map for classes will be provided upon receipt of registration and payment.


FIRST AND LAST NAME: _________________________________________________________________


ADDRESS:  _______________________________________________________________________________


CITY: ________________________________________  STATE: _____________ ZIP:  _________________


PHONE with Area Code:  ____________________________________________________


EMAIL: ______________________________________________________________________

COURSE I: Intro to Esoteric Healing

Please check amount you are enclosing:


____    Full Class Fee $390

____    Register with a friend and you both

              receive a $50 savings in your class fees ($340)

           Friend's Name _________________________________

____    Class Repeat Fee:  $100

____    $50 Deposit (non-refundable) reserves your space

____    Balance to be paid on or before first day of class


Would you like a list of local lodgings:   ___Yes  ___No


____ Energy Healing Treatment $70.00

If you have any questions, please contact Claudia Rose via email at or by phone at (802) 933-6107


Privacy Policy: We will never share, sell, or rent your personal information.


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