Registration Form for Classes Taught by Janna Moll

REGISTRATION FORM Classes Taught by Janna Moll, Heart Healing Center, Inc.
Print this page and fill out the form, using the information from the Class Registration page. Mail with your payment to Janna Moll, Heart Healing Center, Inc. PO Box 632253, Highlands Ranch, CO 80163-2253. If you have questions, please call the Local Coordinator or call Janna at 303-346-3809.
Class Title:
Class Date:
Your name:
Address:
City:	State:	Zip:
Home phone:	Work phone:
E-mail:
Write in the amount of the class you are taking. Amount Enclosed:	I can bring: __ Massage table __ Pillow//blanket
Check number:	__ I need lodging information and directions