I
Haymanootha Healing Certification
  Application Request

I would like to apply for the opportunity to study to become Certified in  the Haymanootha Healing modality.  I understand that if I am accepted, I will be notified of the time, dates and locations of the classes and will be emailed the enrollment directions.  I further understand that each of the six (6) weekend classes that I am requred to attend has a fee of $225.00, which is payable in full prior to my attending the class.

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:

Country:


Daytime Phone:
Evening Phone:
Email:
Please list your present
healing credentials.










If you are a minister, please
describe your organization
and/or affiliations.







Select the area(s) that you
would like to attend your
weekend classes in.














 Phoenix, AZ      
 Boynton Beach, 
 Jacksonville, Fl
 Troy, Michigan        
  Joliette, Ill
 Poughkeepsie, NY
 Binghamton, NY
 West NY, NJ

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