Please Enter Class Desired _________________________
Please Enter Date/s Of Class ___________________________
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TOTAL AMOUNT ENCLOSED $_____________
(Credit Cards Are Not Accepted At The Present
Time)
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Mail To:
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Dr. Dottie Graham. |
| Virginia Center For Healing Touch | |
| 148 Brezzy Point Drive | |
| Yokrtown, VA. 23692-3318 |
Please Fill In Form And Return With Your Remittance.
NAME ________________________________________PHONE ________________________
STREET _______________________________________BUS. PHONE ___________________
CITY _________________________________________STATE _________ ZIP ____________
E-mail Address ________________________________________
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