LIFE EMPOWERMENT!
A Practical Approach To
Self-empowerment,
Manifestation and Transformation™
Saturday March 31st
and Sunday April 1st, 2007
Registration Form
Full Name: ___________________________________________________
Address:_____________________________________________________
City: _________________________ State/Prov. ______ Zip Code: _____
Home Phone: ______________Work
Phone: ___________Other: _______
Email
Address:________________________________________________
Three areas
of your life that you expect to Create/Manifest/Transform by participating in
this course and continuing to do this work:
For
example:
Financial
Situation; Relationship(s); Job/Career; etc.
1. __________________________________________________________
2. __________________________________________________________
3. __________________________________________________________
Who
referred you?_____________________________________
Ÿ Tuition: $250 USD
Ÿ EARLYBIRD SPECIAL: Paid
In Full By March 17th $225 USD
Ÿ Dates: Saturday March 31st
& Sunday April 1st, 2007
Ÿ Times: Sat. Registration 9 a.m.-10 a.m. COURSE
Both Days: 10 a.m.-6 p.m.
Ÿ
Location:
A Gathering Place, North Port Bldg.
12131 Dorsett Rd., Suite 101, Maryland Hgts., MO
Payment Options
· In advance by ( )Check ( )Money Order or ( )Cashier's Check for
$250 USD (OR $225 Earlybird) Payable to Joe Rumbolo
· In advance online through PayPal
accepting all major credit cards $250 USD (OR $225 Earlybird) 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 Joe Rumbolo, WITH COMPLETED REGISTRATION FORM to:
Joe Rumbolo/6425 Lansdowne Ave./St. Louis, MO 63109
Joe at 314-353-3218 or 314-753-0792 or Joe@HealingTheUniverse.com
Walk-ins the day of the
course are welcome! Cash, Checks & Money Orders are acceptable.
Arrangements for
PayPal/Credit Cards can be made.
Signature: ___________________________________Date:____________