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

____ Energy Healing Treatment $70.00

If you have any questions, please contact Claudia Rose via email at

 claudiarosevt@gmail.com or by phone at (802) 933-6107

 

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