MANIFESTING THE LIFE YOU WANT!

October 15 & 16, 2005 Registration Form

 

Full Name: ___________________________________________________

 

Address:_____________________________________________________

 

City: _________________________   State/Prov. ______ Zip Code: _____

 

Home Phone: ______________Work Phone: ___________Other: _______

 

Email Address:________________________________________________

 

Three things that you expect to manifest in your life by participating in this course and continuing to do this work:

 

For example:

 

Ideal Financial Situation; Ideal Relationship; Ideal Job/Career; etc.

 

1. __________________________________________________________

2. __________________________________________________________

3. __________________________________________________________

 

Who referred you?______________________________________

 

( )Friend   ( )Relative   ( )Email Promo   ( )Flyer   ( )Media Ad  ( )Other

 

Tuition:  $199 USD or $249 CAD  Dates: Sat. & Sun. Oct. 15 & 16, 2005

 

Location: Best Western Burlington Inn and Suites

                   2412 Queenway Dr./Burlington, Ontario  L7R 3T3                  

                   905-639-2700 For Accommodations Contact Saif Rehmen at the hotel

 

Payment Options

·                     In advance by ( )Check  ( )Money Order or  ( )Cashier's Check for $199 USD Payable to Joe Rumbolo  or $249 CAD to Tracey Ruggiero

·                     In advance online through PayPal accepting all major credit cards $199 USD + $7 service charge = $206 USD (Email address for PayPal: Joe@HealingTheUniverse.com)

·                    WE ALSO ACCEPT CASH (but please, not through the mail!)

 

Please mail all Checks, Money Orders and Cashiers Checks Payable to Tracey Ruggiero (CAD) or Joe Rumbolo (USD), WITH REGISTRATION FORM

 

To: Tracey Ruggiero/311 Annabelle/Hamilton, Ontario

 

Contact Tracey at 905-388-0490 or Spaceholder@sympatico.ca

Contact Joe at 314-353-3218 or email Joe@HealingTheUniverse.com

 

Walk-ins the day of the course are welcome! Cash, Checks & Money Orders are acceptable.

Arrangements for PayPal can be made in advance.

 

Signature: ___________________________________Date:____________