bmsreiki.com -- Class Registration Form

REIKI TRAINING CLASS REGISTRATION FORM
TO REGISTER FOR REIKI TRAINING:
Copy and e-mail or snail-mail completed form below, with $50 deposit check made payable to:

		Barbara M. Simmonds, M.A.
		954 Aurora Avenue
		St. Paul, MN 55104

Registration form & reservation deposit must be received 1 week prior to class.

Deposit will be applied toward total. Total tuition is due at beginning of class (see payment plan).

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*REGISTRATION FORM REIKI TRAINING * Barbara MacKay Simmonds, Reiki Master/Teacher**


NAME___________________________________________
Address____________________________ City & State__________________ ZIP_______
Phone: day (____)___________ eve (____)__________ cell/pager (____)__________
Email address___________________________________

DATE OF CLASS_______________________

NAME OF CLASS (Check one):

____ Reiki Level I ____ Reiki Level II ____ Reiki I & II for Healing Professionals ____ Japanese-Usui Reiki Techniques (JURT) ____ Advanced Reiki ____ Reiki Master/Teacher

METHOD OF PAYMENT (check one):
	____ I will pay balance at beginning of class ____ I will use post-dated check plan*
	*Payment plan: $50 deposit, plus 3 postdated checks, each for 1/3 of remaining balance, to be dated first of each month for 3 months following class. (E.g. "Deposit" check 5/26, and 3 post-dated checks 6/1, 7/1, 8/1)

PAYMENT:
	$_________ Class Fee Level I: $160; Level II: $160; Advanced: $185; I & II for Healing Professionals: $255; JURT: $255; Master: $650 $_________ Continuing Education Units certificate fee: $5 (optional) $_________ SUBTOTAL $_________ Less deposit $50 $_________ Amount enclosed $_________ Total due at beginning of first day of training

REIKI TRAINING CLASS REGISTRATION FORM