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Awakened Healer™

Awaken Body, Mind and Spirit

 

 

Quantum-Touch® Basic Workshop Registration

 

Once you have completed the Registration Form on this page, click "Submit," and you will receive a Confirmation page. Click "continue" on the Confirmation page, and you will be routed back to this Registration page. At that point, please click here to pay online via PayPal or for information on paying by check. 

 

If for some reason registering through this form poses a problem for you, please email us to to obtain a hardcopy Registration Form.

Name *
E-mail Address *
Date & Location *
Address *
City or Town *
State *
Zip Code *
Telephone - Home *
Telephone - Work
Telephone - Cell
Form of Payment * I am paying online.
I am paying with a check.
How Did You Find Us? * Through the Quantum-Touch website.
Through a Friend.
Through an Internet Search.
If through an Internet search, what phrase(s) did you use? Thank you so much for your help!
Have You Taken a Quantum-Touch Basic Workshop Before With a Certified Quantum-Touch Instructor? *

* Fields marked with an asterisk are required fields

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IMPORTANT: Please note that you will not be considered fully registered until we have received your deposit. If you are paying by check, we will register you provisionally for three days once we receive your registration form; if we have not received your check by then, you will be moved to our waiting list until we receive your check.

Awakened Healer, LLC

  Awaken Body, Mind and Spirit

Padma Desai   padma_desai@yahoo.com   (973) 214-8094