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Online Reiki Class Registration Form

(Please note:  This registration page is designed to work with Internet Explorer.  If you can't seem to make it work, please copy this page and send all information via email, link below.)

Please complete the class registration form below.  When you click the 'Continue' button, there are just two more simple steps in your registration process, following which you will receive your documents concerning:

  • How to prepare for your class

  • All your class materials

  • How to access your on-line class

  • Your class bulletin board

General:

Please tell me your name:  

To receive your Reiki Certificate, please enter your mailing address & check for accuracy!

                              Street:                                           

                              City:   

                 State/Province:    Zip Code

                       Country:              Other (Specify)

 

What is your gender?                             Date of birth?,

 Email address?                

Phone #:   Country Code:  -Area Code:--

 

Class for which you are registering:

 

 Class for which you are registering: 

Please note that all on-line class times are Eastern Time unless otherwise arranged

If you are registering for Reiki Second Degree Therapist, please enter:

    The name of your Reiki Master for Reiki I:

    Her/His Phone Number: (Country Code)   (Area Code)--

    Date you were certified (MM/DD/YY):    

Please enter your name as you would like to have it appear on your Certification:

                          

Use this space to add any comments you might have: