Fraser Counselling Services

EDxTM Registration Form

Energy Diagnosis and Treatment Methods

EDxTM Registration Form (Please Print)

Name: ___________________________________________

Address: ______________________________

Phone: ____________ Fax: ______________ e-mail: _____________

Please Indicate Desired Date/Location:

EDxTM – Energy Diagnosis and Treatment Methods, Certification Program

Level I - Coming Soon!

Level II – Coming Soon!

Level III & IV – Spring 2002, Toronto, Ontario (Taught by Fred Gallo)

Fee: $ 375 (includes GST) Please make cheque payable to: Susan Fraser

Pay by: Cheque Visa Visa # ___________________ Expiry ___/______

Name_____________________ Signature __________________________

Send to: Fraser Counselling Services

Or For More Information About This or Future Training Programs Please Contact Us:

256 King St. N.                              Call: (519) 884-1029 Fax: (519) 884-1427
P.O. Box 38007                              Toll Free: 1-877-392-7954
Waterloo, Ontario, N2J 4T9             e-mail: sue@frasercounselling.com