If you have taken the Theta Healing 
basic training class, and are seeking clients, 
you are invited to add your name to our website practitioner's list.

http://www.ReligionAndReality.com/tht-77-practitioners.html°

Please print clearly.  

Your Name:    ___________________________________________________  

Physical Location:   (From where are you seeking clients)

Personal contact: (i.e.  Los Angeles area)  ____________________________

By Phone:    (i.e. Anywhere)    ____________________________________

Your Phone Number:         Area Code  __________   PH # ___________________

Postal-mail Address:         Street Address  _______________________________

City  ________________________________State  ___________ Zip  ______

Add my address to the website  (      )             Keep my address private (      )  

E-mail Address:   _________________________________________________

Website:   ______________________________________________________

Are you willing to exchange website links?     Yes   (    )    No   (    )     

Preferred Method of receiving initial contact from potential clients: 

Phone:   (    )    Email   (    )     Postal Mail   (    )

Preferred method of working clients: 

Phone:   (    )    personal contact   (    )      Either   (    )

Tell the world who you are.   About yourself:   

_____________________________________________________________   

_____________________________________________________________   

_____________________________________________________________   

Signature:    ____________________________________________________  

Date:    _________________________________________________________

http://www.lifecoach4vip.com/th-027-seeking-clients-form.html