EMF Balancing Technique® Practitioner’s Training Registration
Please print and mail completed form with check payable to: Magnificent Voyage, LLC // 715 Hill Street, Suite 207 // Madison, WI 53705

Name ______________________________________________________

Date of Birth _____________________________ Male_____Female____

Address_____________________________________________________

City_______________________________State_________ Zip ________

Telephone - Home (     )____________ Work (    )__________________

Occupation_____________________Email________________________

How did you hear about the EMF Balancing Technique® ?____________

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What is your energy background? _______________________________

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Can you bring a massage table? _____________

What is your primary reason for wanting to learn the technique? (Are you
adding this to an existing practice, building a new business, or using as
a tool for personal growth?) ____________________________________

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Is there anything else you would like us to know about you?__________

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Dates you are registering for: ___________________

Amount of deposit ($100.00 per phase): _____________________
Deposits are non-refundable, but may be transferred.

Signature____________________________________________