Note: an interview with Instructor Mary Elizabeth Raines is required before acceptance into the Guided Imagery certification program. Please print and fill out the below form only if you have already completed your interview. Mail completed form, together with your deposit, to the address listed at the bottom of the page.
Academy for Professional Hypnosis Training
GUIDED IMAGERY TRAINING
FULL NAME (Please Print)___________________________________________________________________________________________________________________________________________
NAME BY WHICH YOU WOULD LIKE TO BE CALLED_______________________________________________________________________________________________________________________
MAILING ADDRESS ______________________________________________________________________________________________________________________________________________
DATE OF BIRTH ______________________________________________________________________________
EDUCATION OR OTHER TRAINING YOU HAVE HAD WHICH MIGHT BE PERTINENT TO GUIDED IMAGERY COURSE:
BRIEFLY DESCRIBE YOUR INTEREST IN STUDYING TO BECOME A GUIDED IMAGERY COUNSELOR:
PLEASE SHARE ANY PERSONAL CONDITIONS INCLUDING MEDICAL HISTORY/SERIOUS ALLERGIES/OTHER CIRCUMSTANCES OF WHICH WE NEED TO BE AWARE:
NAME, CURRENT PHONE NO. & EMAIL OF EMERGENCY CONTACT___________________________________________________________________________________________________________________________________________________________________
DEPOSIT ENCLOSED IN THE AMOUNT OF: _______________($225.00 US dollars minimum)
Registration and deposit must be postmarked by the above date to qualify for any potential discounts. Sorry, but there can be no exceptions under any circumstances. See below for discount and refund policy.
Call us if you have extra deductions for bringing along a friend: (928)282-2640
Note to students: Your registration is your commitment to take the class. Our commitment to you is that we will hold the class as scheduled, barring circumstances called "acts of God." The below refund policy is in place since our commitment entails making a substantial, nonrefundable deposit for multiple items as supplies, catering,office work, airfare, classroom space rental & lodging.
DISCOUNT AND REFUND POLICY
Tuition discounts, if any, are only applicable if deposit has been postmarked by due date and balance is paid before or on the first day of class. Discount for bringing a friend is only applicable if both parties enroll in and pay for entire course in a timely fashion. In the event of any delay in payment, all discounts will be null and void.
Refund policies: a minimum deposit of $225 is required to enroll. The deposit amount, minus a $40 bookkeeping fee, is completely refundable up until four weeks before the beginning of class. From four weeks to one week before the start of class, refunds will be given for any amount in excess of $225; the remainder is non-refundable, however $185 may be applied to another Academy for Professional Hypnosis Training program if the cancellation is due to a verifiable medical or family emergency (legal documentation required; no exceptions). Starting one week before the opening of class and continuing after class begins, there will be no refunds.
Back to Course Details
Web design by Mary Elizabeth Raines