Reiki Courses in Gloucestershire Application Form

Welcome to our Reiki Courses in Gloucestershire 2021

Application Form
Janie Whittemore of janiewhittemore.com runs courses at different venues and spaces, Gloucester, Cheltenham and Cirencester.

To book a Reiki course in Cheltenham or Gloucester, use this application form. To book a course at The Cotswold Academy in Cirencester, please go to their website.

Your place is reserved on receipt of payment and once this form is received and accepted. Please make sure you use the right course reference number and - IMPORTANT - your name with your bank transaction so I know it is you!
PERSONAL INFORMATION
Name *

First Name Last Name
Name 2 *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Post Code
Email Address *
example@example.com
Phone Number *

Area Code Phone Number
RELEVANT PREVIOUS TRAINING
Please list any training or experience related to Reiki or other forms of healing that you have undertaken, adding new lines where needed
Student 2: Please list any training or experience related to Reiki or other forms of healing that you have undertaken, adding new lines where needed
Student 3: Please list any training or experience related to Reiki or other forms of healing that you have undertaken, adding new lines where needed
Student 4: Please list any training or experience related to Reiki or other forms of healing that you have undertaken, adding new lines where needed
Please list any medical conditions and medication that may affect your comfort / suitability for the course *
How did you hear about Janie Whittemore's Reiki Courses?? *

Word of Mouth via Janie Whittemore directly Google or internet search Facebook event Idun Spirit Isbourne Centre
Which course are you applying for? *

Level 1: 22 April Chelt Private class Course Ref: L1-220421 Level 1: 11 Jun Idun Spirit £149 Course Ref: L1-110621 Level 2: 1-2 July Idun Spirit £249 Course Ref: L2-010721 Level 1: 5 Aug Idun Spirit £149 Course Ref: L1-060821 Level 2: 2-3 Sept Idun Spirit £249 Course Ref: L2-030921
PAYMENT INFORMATION

Payment to be made by direct banking to

The Healing Company
Acct No: 24922897
Sort Code: 60-05-16

Ref: please use [SURNAME} + COURSE REF NO on the transaction
Enter your NAME + COURSE REF BELOW as you will put on your bank transaction so I know who has paid and for what. ie JONES L1010820
Date paid in to the above account: *
Amount paid in:
Amount in Pounds
Please read the information sheet about your course and the terms and conditions. You may want to print and keep for your reference.
Marketing

Yes, I am happy to have my email address used for course information and healing sessions by Janie Whittemore
Newsletter

Yes, subscribe me to the occasional news from Janie Whittemore at The Healing Company
signed

I have read and agree to the terms and conditions
Name

First Name Last Name
THANK YOU
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Welcome to our Reiki Courses in Gloucestershire 2021

PERSONAL INFORMATION

RELEVANT PREVIOUS TRAINING