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.

TODAY'S DATE: _________________________________________

FIRST AND LAST NAME: _________________________________________________________________

 

ADDRESS:  _______________________________________________________________________________

 

CITY: ________________________________________  STATE: _____________ ZIP:  _________________

 

PHONE with Area Code:  ____________________________________________________

 

EMAIL: ______________________________________________________________________

Please check one:

____  CLASS 1: Intro to Esoteric Healing

____  CLASS 2: Integrated Living

____  CLASS 3: A Cosmic Perspective

____  CLASS 4: The Bridge Of Light

____   All 4 classes

ENERGY HEALING TREATMENT

____ 1-Hour Treatment $70.00

____ 30-min. Treatment $50.00

Please check amount you are enclosing:

____    Full Class Fee $490

_____   Early Registration $440 (4 wks prior to class start date)

____    Class Repeat Fee:  $150

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

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

____    3 classes for the price of one Fee: $1470

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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