Reservation Form for IET Basic Healing Meditation Workshop for Adults


THIS WORKSHOP IS FOR: Adults who want to confront and resolve their personal problems and find meaning in life. (Personal problems pertain mainly to emotional trauma, bad relationships and lack of self-fulfillment).

EXCLUDED ARE: Those who have (1) serious medical problems such as imminent heart attack or stroke and (2) severe psychiatric illnesses such as schizophrenia, psychosis, suicidal depression and uncontrollable aggression.

DURATION: one month, four sessions, 2 hours per session.

LOCATION: To be announced.

FEE: Fee (to be announced) excludes food and lodging

CONDITIONS:

1. The applicant must first read the "I" Empowerment Manual for full disclosure of the workshop before making any reservations for the workshop.

2. The applicant hereby frees IEI of any liability during the workshop.

Reservation Form:

Name:		Gender:
Age:		B-day:
Nationality:		Occupation:
Address:		Religion:
Phone:		Fax:
E-mail:

	Do you have any serious physical illness? Please explain.
	Do you have any serious mental or psychological illness? Please explain.
	Have you had any experience in meditation? Please explain.
	Have you had any experience in psychology workshops? Please explain.
	Have you experienced any regression therapy ? Please explain.
	Do you have any specific needs during the workshop, such as food or medicine?
	I have read and understood the "I" Empowerment Therapy Manual. I agree to the terms mentioned above.