3 Yr. Registration Form

STUDENT REGISTRATION FORM

LAST NAME______________________

FIRST NAME______________________

ADDRESS_________________________

CITY STATE ZIP___________________

HOME PHONE_____________ WORK PHONE____________

FAX______________ DATE OF BIRTH______________

EMAIL______________ SOCIAL SECURITY #_______________

EMERGENCY CONTACT_________________________

 

3 YEAR COURSE

Self Healing 4 weeks in Year 1

Healing Others 4 weeks in Year 2

Spiritual Mastery 4 weeks in Year 3

 

Option 1: Per Year Basis

REGISTRATION FEE (non-refundable) $ 50.00

COURSE MATERIALS $ 100.00

TUITION DEPOSIT $2100.00 due at time of registration

TOTAL AMOUNT ENCLOSED $2,250.00

PAYMENT

TUITION TOTAL $3200/yr

Less Deposit 2,100.00

Balance $1,100 due one week prior to first day of second session each year

 

Option 2: Per Course Basis

REGISTRATION FEE (non-refundable) $ 50.00

COURSE MATERIALS $ 25/class

$950/5 day course

$300/5 day course -Room and Board

TOTAL COST $1,325/class ($1,025 w/o Room and Board)

Payment must be post-marked one month prior to start of course

PAYMENT METHOD

Visa___ Master Card____ Check____

Money Order____

Credit Card Number:______________________

Exp. Date: ____________AMOUNT____________

Name (as appears on card)_________________

Billing Address (Street Address, City State, Zip Code)

____________________________________________________

Signature of Card Holder

PLEASE COMPLETE THIS FORM AND RETURN WITH

PAYMENT.

I agree that if for some reason I cannot keep this commitment $500.00 of my

tuition deposit will be refunded to me if I notify the office 10 days prior to

start date of the course.

 

After that date, I agree the tuition deposit and the fee for course materials

becomes non-refundable and no money will be refunded under any

circumstances.

_________________________

Student signature

Date

Name (Please print)________________________

Please submit original and keep a copy for your records.

TUITION COSTS

The Heart Awakening School of Healing has done its best to maintain the

high quality and standards of the work while keeping its fees as affordable as

possible.