Enrolment Form for level 1
Full name
(as required on the certificate)
Date of Birth :
Residential Address :
Phone/ Mobile Nos. :
E-mail Address :
Introduced to this session by :
Profession : Designation :
Your Reasons for participating in the Seminar? :
Declaration Form

I am participating in this programme Healing workshop Reiki Level 1 of my own free
will and declare that I am physically and mentally fit to participate in the seminar.

I am enclosing Cash or NET transfer
(please tick mark payment option )
Place :
Date :