Enriching Education Disguised As Fun

INFORMATION REQUEST FORM
YOUR NAME:
MAILING ADDRESS:
CITY:
STATE:
COUNTRY:
ZIP CODE:
PHONE NUMBER:
E-MAIL ADDRESS:

I am interested in the following training or retreat: 
(Please check all that apply)
NLP Practitioner 

NLP Master Practitioner 

Coaching 

Clinical Hypnosis 

Reiki

Reiki Master

Soul Memory Retreats

Allergy Relief Workshop

Self Hypnosis Workshop

 Neuro-Linguistic Hypnotherapy™
          Includes: 
           Clinical & Ericksonian Hypnosis 
          NLP & NLP Master Practitioner 
          Time Line Therapy™ 
          Reiki levels I & II

 

Corporate Training & Communications
Applied Professional EXcellence Seminar (APEX)
Becoming Safety Unconscious Seminars

A tailored program held at my corporate location
Please specify your interest:
Professional Certification

Personal Enrichment

Career Development

Spiritual Development

Mastering Communication

 Please specify desired training location (s):
Seattle, Washington USA

San Diego, California, USA

Friday Harbor, Washington USA

Sedona, Arizona, USA

Hawaii

The Netherlands

Would like to see a course scheduled:

on a Caribbean Cruise Ship
in Belize

in Brazil

in Thailand
Questions? Comments:

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1324 N. 77th. Street, Seattle Washington 98103 Call Free 1-888-432-1122