HEALING TOUCH CLASS REGISTRATION

Please Enter Class Desired _________________________

Please Enter Date/s Of Class ___________________________


 
Please Check One :
 
Member
 
NonMember

TOTAL AMOUNT ENCLOSED $_____________
(Credit Cards Are Not Accepted At The Present Time)



 

Mail To: 
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 ________________________________________