The Healer Teacher
I Program
Registration
Form
Please print this
form, fill it out and send with your check or money order to:
Mystical Sciences Institute
P.O. Box 1146, Evanston, IL 60204
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Date
of Class:
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August
23, September 13, October 4, |
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Time
of Class:
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Sunday's 1:00-4:00pm | ||
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Location:
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MSI Class
Room The Greal Hall of Learning |
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Name
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Address
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City,
State & Zip
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Telephone
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Email
address
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Correct
name for certificate
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Total
Amount Submitted
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$
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Check
or
Money Order # |
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The
Fee is $495.00 per person.A non-refundable deposit of $100.00 is
required to hold your seat. All students must be registered and paid
in full by August 23 2008.
There is a limited amount of seating and classes fill up quickly so
please mail this form in
with your deposit. You will receive a confirmation call following the
receipt of your registration.
Visa/MC/American Express/ Discover accepted.
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Office
use only
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| Date Rec'd | initials
of staff member recording info |
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| Date Data entry complete | Date confirmation call | date
Filed/assigned books & material |