hypnosis

        

 
Center for Personal Power 
1325 E. Thousand Oaks Blvd., #200
Thousand Oaks, CA 91362 
818-974-8245 
 
Fill out the below, print this page and send to Center for Personal Power 
 Registration for Hypnosis Training
Saturday and Sunday, August 21, 2010 through September 26, 2010 

 Yes, please register me for the Exciting World of Hypnosis, 6 week training and certification course.

I understand that upon completion of course, and passing a written final examination, I will have earned the title of
Certified Hypnotherapist,
 certification through Center for Personal Power and the National Guild of Hypnotists.

 

Name: _____________________________________________________________

 

Address: ____________________________________________________________

 

City/State/Zip: _______________________________________________________

 

Phone: (Home/Bus/Cell)_________________________________________________

E-Mail: _____________________________________________________________

 

Program Prices:

 

[ ] $1,250.00 at the door. ($200 deposit required to reserve seat)

 

[ ] $ 950.00 when paid in full prior to August 1, 2010

 

 Payment method: Check [    ] MC [    ] Visa [     ] AMEX [     ]

 

Card #: ________________________________________________

 

Exp Date: ______________________________________________

 

Security Code: ___________________________________________

 

  Signature: ________________________________________________________


 Date: __________________________________