Reiki & Buddho-EnerSense Application Form


Please Print and Post - Information given on this form is held in the strictest confidence
Telephone reservations should be followed up within 7 days with a completed application form and deposit.
Verbal reservations are held only for 7 days.
 Name
 Telephone
Address & Post Code

 Fax/ E-Mail/ Occupation
Previous Reiki Training    Please give names of previous teachers, lineage and dates at each level.   Copies of certification should be sent with your application.
 Previous Spiritual Studies
 Training in healing modalities  Training in allopathic medicine
Course/studies requested.
Please circle choice(s)

Reiki 1 / 2 / 3  
Buddho/EnerSense 1 / 2 / 3
 Course date requested

1st Choice ________
2nd Choice ________

Agreement & Statement of Intent:
I .................................................................. agree to hold the teachings I receive from the courses attended as confidential and to respect the Lineage of Master/Teachers in the Eastern Tradition of Usui Reiki known as the Lineage of Takamori: Reiki Jin-Kei Do. I agree not to pass on the material to others, including such methods as sharing, bartering, exchanging and teaching without the consent of the course tutor/initiating master. I agree not to physically copy all or any part of the course material without the tutor's consent and not to use or misuse the material in any product for sale or as gifts.
Signed .................................................................. Date..........................

I enclose a cheque for ______ (payable to G & D Bell) as deposit.
Please make a copy of this form for your own records. Send to Gordon & Dorothy Bell, Little Court, Bannerdown Road, Batheaston, BATH, Avon BA1 7NE U.K.

Please use the reverse of the sheet for writing further information, such as the reasons you would like to take this training and any additional information requested.
Acceptance on a course of training is subject to assessment as to our suitability as the appropriate teachers for you. Therefore, completion of this form does not constitute acceptance for training.

Please print out and post.

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