Fraser Counselling Services - Energy Psych Reg

ENERGY PSYCHOLOGY TECHNIQUES

Energy Psychology Techniques Registration Form (Please Print)

Name: ___________________________________________

Address: ______________________________

Phone: __________________ Fax: _______________ e-mail: ______________

Please Indicate Desired Location:

2004:
Oct 29-30 (Fri - Sat) Stratford

2005:
Jan 22-23 (Sat-Sun) Toronto

March 7-8 (Mon-Tues) Ottawa

Fee: $ 370.00 plus $25.90 GST

Make cheque payable to: Susan Fraser

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

Name_____________________ Signature __________________________

Send to: Fraser Counselling Services
For More About This or Future Trainings Contact Us:

256 King St. N.
P.O. Box 38007
Waterloo, Ontario, N2J 4T9

Call (519) 884-1029 Fax: (519) 884-1427
Toll Free 1-800-392-7954
e-mail: sue@frasercounselling.com