Application for
Entering The Healing Temple®
3-Month Training

YOUR CONTACT INFORMATION
Name *
Name
Address *
Address
Phone *
Phone
ABOUT YOUR BUSINESS
http://
MORE ABOUT YOU
Payment plans are available and will cost more; talk to Katherine.
Are you comfortable using computers, email, etc.? *
AND, FINALLY...
If you were referred by someone, who may we thank for your referral?