for REIKI Workshop
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Registration for REIKI Workshop |
| Space is Limited in this Workshop. Register EARLY to ensure your attendance. PLEASE MAIL, e-MAIL OR FAX THIS FORM TO CLEAR LIGHT ARTS, ADL Name: _________________________________________________________________________ Address: _______________________________________________________________________ City: _______________________________________ State: ___________ Zip: ______________ Daytime telephone: _______________________________________________________________ Evening telephone: _______________________________________________________________ Fax: __________________________________________________________________________ e-mail: ________________________________________________________________________ Have you experienced a REIKI individual or group session? If yes, feel free to detail your experiences. _______________________________________________________________________________ _______________________________________________________________________________ What brings you to your interest in learning REIKI? _______________________________________________________________________________ _______________________________________________________________________________ Which Level of REIKI are you planning on attending? ______________________________________ If your interest is REIKI Level Two or REIKI Level Three-Advanced Practitioner, please provide the following: REIKI Level One completion date:_____________________________________________________ Name of REIKI Master who attuned you to REIKI Level One: ________________________________ REIKI Level Two completion date: _____________________________________________________ Name of REIKI Master who attuned you to REIKI Level Two:________________________________ What course date are you planning on attending? __________________________________________ Will you require residential accommodations (lodging)? ______________________________________ Registration Deposit required for all workshops: $75.00
_____MONEY ORDER _____CHECK_____MASTERCARD _____VISA All credits card orders will be charged through our business name: CLEAR
LIGHT ARTS, ADL. Credit card number: ______________________________________________________________ Exp. Date: ____________ Name as it appears on the credit card: ________________________________________________ Signature: ______________________________________________________________________ COPYRIGHT © 1995-2012 CLEAR LIGHT ARTS, ADL., Heart & Soul Healing, HSH, Multidimensional Cellular Healing, MCH, Living Light Breath - Unity Consciousness, INscension, The Third Eye of Horus Mystery School, Gates of Quan Yin, Blended Energy, Bio-Energetic & Holographic RePatterning, are all trademarked names belonging to Ken Page, Rev. Nancy Nester and Clear Light Arts, ADL. All text, graphics and contents© 1995-2011, Clear Light Arts, ADL, unless otherwise noted. Use purpose must be granted by the copyright holder. Unauthorized use, alteration, transformation or reuse is strictly prohibited.
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