CARE Seminar Registration Form

C.A.R.E. Registration Form Location of Seminar__________________________ Dates of Seminar____________________________ Classes___________________________________ Your Name_________________________________ Address___________________________________ City_______________________________________ State/Province_______________________________ Zip/Postal Code_____________________________ Day Phone_________________________________ Evening Phone______________________________ email Address______________________________ Would You Be Willing to Bring a Massage Table? _________________________ 2008/09 ala-Carte Program Pricing Healing Oils of the Bible $ 40 HOB Applied Vitaflex $140 AVF Raindrop I $160 RDT I Raindrop II $160 RDT II Chemistry I $ 110 CHEM I Chemistry II $ 110 CHEM II Emotional Release $170 ER Total ala-carte $890 Full Intensive: $700 (save $120) Students may repeat CARE classes at ½ price with proof of prior attendance. Amt. Paid $_______________________ Check Number __________payable to Energetic Essentials. OR Credit Card: Type: _____Visa______MC CC#______________________________________ Exp. Date__________________________________ C V V#_______________ (3-digits on back) Exact Name on Credit Card _________________________________________ Billing Zip Code of Credit Card _________________________________________ MAIL FORM WITH PAYMENT OR CALL OR EMAIL TO RESERVE YOUR SPACE. Send Registration with payment to: Nancy Gouch 1555 Jasper Drive Wheaton, IL 60189 (630)272-7948 raindroptraining@energeticessentials.com
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