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Registration 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 will be provided upon receipt of registration and payment.

 

 

 

FIRST AND LAST NAME: ___________________________________________________________________________

 

ADDRESS:  ________________________________________________________________________________________

 

CITY: ___________________________________________________STATE: _____________ ZIP:  _________________

 

PHONE with Area Code:  ____________________________________________________

 

EMAIL: ______________________________________________________________________


Please check one:
I am registering for the following Esoteric Healing Class:

 

_____    COURSE I:    Introduction to Esoteric Healing

_____    COURSE II:   Integrated Living

_____    COURSE III:  A Cosmic Perspective

_____    COURSE IV:  Synthesis

 

Please indicate if you would like a list of local lodgings.    yes _____ no_____

 

 

 

COURSE FEES:

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)

_____    Class Repeat Fee:  $100

_____    $50 Registration Fee (non-refundable) to reserve your place in the class

_____    Balance to be paid on or before the first day of class.

 

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

 claudiarosevt@gmail.com

 

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

 

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