Name

First Name

Last Name

Mailing address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which course are you registering for?

Level 1

Level 2

Level 3

All 3 Levels

What is your level of reiki experience?

Have you completed any other reiki certifications?

Prior certification required for levels 2 and 3

(If applicable) Please describe what level(s) of reiki you have completed, date(s), and name of instructor.

What do you hope to get out of this course?

What is your intention for this course?

Choose the 3 payment option if signing up for ONE CLASS for $1,110
Choose the 5 payment option if signing up for all THREE CLASSES for $2,900

Upon registration students will receive a copy of the course syllabus, terms of service, and class meeting times and location.

*Choose the 3 payment option if signing up for ONE CLASS for $1,110*Choose the 5 payment option if signing up for all THREE CLASSES for $2,900