Application of the Inner Processes
of Therapeutic Touch
(Advanced Level) Class Registration

Name*

Address*

City, State, Zip*

Phone*

Email*

Profession*

License (if CEUs are required):

As much as possible, we tailor our workshops to the needs of our participants. To that end, please answer the following:

Briefly describe your Therapeutic Touch practice during the past year. For example, do you work primarily with family members, in a hospital setting, or other?*

Dates, locations, and teacher names for previous Therapeutic Touch classes and events.*

What do you hope to get out of this workshop?*

Please list any other healing modalities you practice. In what setting do you practice them?

Payment method (select one)*:

I prefer to pay online.I prefer to mail you a check.

Refund policy: Class fee is non-refundable except in very limited circumstances.

I have read the refund policy.