About you

If you already completed a registration form, you only need to fill in your name in this section.

Full name (as it should appear on your certificate)

Address

Phone

Alternative phone (optional)

Date of birth

How did you hear about the course? (optional)

Food allergies, sensitivities and preferences

Please say which ones are allergies. Write "none" if there are none.

Application

Your answers are helpful to us. They will help guide our teaching and curriculum design to best meet your needs.

Emergency contact

Emergency contact’s phone

What draws you to this course? What do you intend to get from the course? What is your goal for the course?

Are you planning to become certified in Wholeness Energetics, our system of holistic healing?

Do you have physical or mental health issues? If so, please describe. (optional)

Do you have an issue related to drug or alcohol use? (optional)

Describe your interest and experience in health and healing, whether personal or professional, whether healing others or self.

Describe your journey related to personal growth (transformation, awakening, spirituality, or religion).

Please share any other pertinent information you feel would be useful. (optional)

Payment

A $300 deposit holds your spot. Full tuition (or an approved payment plan) is due before the course begins.

How would you like to pay? Pay the $300 deposit now with PayPal Pay the full tuition now with PayPal Mail a check I’ve already paid, or I’d like to talk about a payment plan

Path of the Healer Application

About you

Application

Payment

Thank you

Returning to Wholeness

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