PROFESSIONAL HYPNOTHERAPY TRAINING

Note:  Preregistration is required. Must be 18 years of age or older.

Please call 850-910-2090 to register:

Fill out and mail in the Enrollment form below with a nonrefundable deposit of $100.00 to hold your place in class.  Balance of tuition is due on or before the first day of class.

If for any reason the class is cancelled, your deposit money will be refunded.

Location:  744 E. Burgess Rd A-101

                  Pensacola,  FL 32504

            Class hours are 9:00am - 5:00pm

I wish to register for the Professional Hypnotherapy Course Beginning on date of______________________________

STUDENT NAME__________________________________________________

ADDRESS____________________________________________

CITY____________________STATE____________ZIP_________

PHONE _______________________________________________

CELL_________________________________________________

EMAIL________________________________________________

Enclosed is a deposit  of $100 to hold my place in class.  I understand that the balance is due before or on first day of class.

                 Make Check Payable to:    Jacqueline Reed C.M.T., C.Ht.

                 Mail form & Check to:        Jacqueline Reed                        

                                                                  744E. Burgess Rd, A-101  

                                                                  Pensacola, FL 32504