Name
Address
City State
Zip code
Phone #
E-Mail address
Why
are you taking this clinic and what are your goals?
Have
you ever experienced energy work and what was your experience?
Please print this form and send it with a check for
$275.00 to :
Cindy
Brody P.O. Box 146 Woodstock, NY 12498
845-679-3393 www.cindybrody.com
CLASS IS LIMITED TO 12 SO PLEASE RESERVE EARLY!
Materials will be provided. Bring beverages.
I look forward to teaching you CinergE!
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