RESERVE: 2 WEEK Sound Healer Training Course

Please fill in the form below to reserve your space on the Two Week Sound Healer Training

23 May - 6 June 2013

Name: *

Surname: *

Email: *

Address: *

City/Town : *

Postal Code: *

Province/county: *

Telephone: *

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Location:

Please indicate the location for the training

How would you rate your knowledge/experience with Sound? :

Beginner

Intermediate

Advanced

Are you a therapist or health practitioner in alternative or allopathic medicine?:

Please explain

Have you experienced altered states of consciousness while listening to music or drums?:

Have you suffered from a serious medical condition or chronic illness?: *

Please explain

Are you taking medication? For what purpose?: *

I agree to pay the first payment of €300 as a deposit and commitment to complete the Training: *

Please complete payment of deposit in our shop, once you submit the form you will be redirected to the Payment Page.

The remaining €1325 (one thousand three hundred and twenty-five euros) I undertake to pay : *

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