7 Mo. 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

 

7 MONTH COURSE

Self Healing 4 weeks

Healing Others 4 weeks

Spiritual Mastery 4 weeks

Healing Practitioner 12 week Practicum

 

 

COURSE MATERIALS $ 200.00

TUITION DEPOSIT $1000.00

TOTAL AMOUNT ENCLOSED $1,250.00

Payment must be postmarked one month prior to start date to avoid late fee of $50.00.

 

PAYMENT

TUITION TOTAL $10,000.00

Less Deposit 1,000.00

Balance $9,000.00

$4,500.00 due on first day of class

$4,500.00 due on or before first day of class

 

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 one week prior to the session date.

 

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.