print app to healing light retreat

School of Light Body Medicine

Application to attend the Regenerative Soul Therapy Practicum:
Living Light Healing Retreat

Please print this form from your
web browser and mail it
with the seminar fee to:

Rev. Magdalena Light
P.O. Box 189
Havre de Grace, MD, 21078
U.S.A.

To participate in this program it is not required that you attend all sessions, In order to attend any desired session, your application for attendance with your non-refundable seminar fee of $100 must be received 7 days prior to each session.

If you would like to sign up for the complete 12-week retreat, the fee is $1,000, payable 7 days prior to the start of the course. Application for attendance of any and all sessions will be processed on a first come first served basis. The number of participants accepted is limited. If you want to secure your place, you may want to sign up for the entire series in the beginning.

The Living Light Healing Retreat will be offered for 12 sessions,
on Sunday and Monday, every other weekend beginning April 4, 2004.

Philadelphia, PA
9:00 a.m. to 6:00 p.m.

print calendar

*Select all 12 sessions:*
	Sign me up for all 12 sessions	$1,000

*Or select any of the following sessions:*
Session 1	April 4, 2004	$100
Session 2	April 4, 2004	$100
Session 3	April 18, 2004	$100
Session 4	April 19, 2004	$100
Session 5	May 2, 2004	$100
Session 6	May 3, 2004	$100
Session 7	May 16, 2004	$100
Session 8	May 17, 2004	$100
Session 9	May 30, 2004	$100
Session 10	May 31, 2004	$100
Session 11	June 13, 2004	$100
Session 12	June 14, 2004	$100

*Please print the following information:*
First Name
Last Name
Street Address
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

Seminar Fee: $100 for each session or $1,000 for all 12 sessions

Enclose Money Order (no personal checks please) or
Charge my seminar fee to the following:
	Visa
	MasterCard

Please take this chance to donate and help me build the Temple of Living Light everywhere. No amount is too small, no amount is too big. All amounts are just right and right now. Any amount not donated is an opportunity lost in world service.

Please accept my donation of $________ to Rev. Light
to help her build the Temple of Living Light everywhere

Please note: Donations are entirely voluntary and are not related in any way to the application process.

Total enclosed:

*Credit Card Information:*
Card Number
Expiration Date
Card Holder information if different from registrant	First Name
	Last Name
	Address
	City
	State
	Zip
	Country