EMPOWERED HEALING FOR YOURSELF, HORSES/PETS AND OWNERS - APPLICATION FORM V2.

To secure a place on one of our workshops please print and complete the following form
and return to the postal address below. We will contact you as soon as we receive your
application form to confirm your requested dates. Your payment will only be processed
after your workshop date has been confirmed to you.

Caroline Booth BHSI/Healer Reiki master,
22 woodland Hills
Madeley
Crewe
Cheshire
CW3 9HN

For Further Information please Telephone. 07759 225654 or e-mail caroline@empoweredhealing.co.uk

I WOULD LIKE TO BOOK A PLACE ON THE FOLLOWING COURSES AND
PROVIDE A NON-REFUNDABLE DEPOSIT BY CHEQUE, OF:
£50 FOR EACH REIKI COURSE OR
£20 FOR EACH OF THE OTHER COURSES.

COURSE AND DATE

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2___________________________________

3___________________________________

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5___________________________________

NAME______________________________

ADDRESS___________________________

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CONTACT NUMBER_________________________

EMAIL ADDRESS____________________________

LOVE LIGHT AND BEST WISHES