Name:
Phone: E-mail:
Address:
City and State:
Work Experience and Expertise:
Personal Process History:
To register, please print out and complete this application along with a separate page giving a brief autobiographical sketch and what drew you to this program, and send it to the address below, along with your $300 deposit.
Thank you so much for your interest in our program. If you have any further questions, please call Chalsie Flannery at 530-575-9038 for further information.
Mail to:
The Healing Academy
228 Commercial St. #264
Nevada City, CA 95959