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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_____





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


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


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