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Long Island Feng Shui Institute REGISTRATION
FORM FENG SHUI MASTERS PROGRAM 2010-2011 programs |
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Feng Shui Masters Program: 9:00 am - 5:00 pm daily
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APPLICANT INFORMATION: NAME__________________________________________________________________________ ADDRESS:______________________________________________________________________ CITY:_________________________State______________________________ZIP_____________
TELEPHONE:
HOME___________________________OFFICE____________________________ E-MAIL:_________________________________________________________________________
SIGNATURE_____________________________________________________________________ METHOD OF PAYMENT: AMEX
VIXA MC (CIRCLE ONE) CARD #
___________________________________ EXP. DATE___________________________ Make check/money order payable to : LONG ISLAND FENG SHUI INSTITUTE
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