MSI
Mystical Sciences Institute
(847) 866-0505

 

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info@msi-healing.com

 

The Spirit of Food

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


Date of Class:

May 6, 20,
June 3, 24,
July 8, 22
Tuesday's

Time of Class:
6:30- 8:00pm
Location:

MSI Classroom - The Great Hall of Learning
2153 Ashland Ave. Suite #3 Evanston IL. 60201

Name:
 
Address
 
City, State & Zip
 
Telephone
 
Email Address
 
Total Amount Submitted
$
Check or
Money Order #
 

The program fee is $550.00. A nonrefundable deposit of $100.00 is required to hold your seat.
All students must be registered and paid in full by MY 6 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.

Office use only
Date Rec'd initials of staff member
recording info
Date Data entry complete Date confirmation call date Filed/assigned
books & material