Your First and Last Name

Email Address

Name of the class for which you are now registering:

Class Date

Do you consider yourself a beginner, intermediate or advanced in working with energy for yourself or with others? Do you consider yourself a beginner, intermediate or advanced in working with energy for yourself or with others? Beginner Intermediate Advanced

Do you have a meditation practice? Do you have a meditation practice? Yes No

If yes, how often and how long do you practice?

What other energy healing skills are familiar with? Such as Reiki, mediumship, etc

What other energy healing skills are familiar with? Such as Reiki, mediumship, etc

Please explain your knowledge of energy and how it relates to the human being and healing the body/mind/spirit.

Are you familiar with the use of a pendulum for obtaining information about your energy field. If so, explain what your experience has been with this form of communication.

What is your knowledge of self healing?

What do you expect to get out of this class?

Please share any other information about yourself and your current understanding of energy healing that I could use to help me give you the best possible experience in my class.