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
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