Course Registration Outstation (India)

THIS FORM IS FOR OUTSTATION (INDIA) CLASSES ONLY. FILL CANDIDATE'S DETAILS.

EMAIL ID

FIRST NAME

LAST NAME

FATHER'S / HUSBAND'S NAME

DATE OF BIRTH

GENDER
---MALEFEMALETRANSGENDERPREFER NOT TO SAY

MOBILE NUMBER

ALTERNATE NUMBER

YOUR ADDRESS

CITY / TOWN

STATE / PROVINCE

COUNTRY

POSTAL / PIN CODE

PROFESSION / DESIGNATION

HOW DID YOU HEAR ABOUT US?
---WEBSITEFACEBOOKYOUTUBEWHATSAPPFAMILYFRIENDINSTAGRAMGOOGLE SEARCHTWITTERLINKEDINNEWSLETTERNEWSPAPER ARTICLETELEVISION MEDIAOTHERS

SELECT COURSE/S
*COMBO* USUI REIKI (LEVEL 1&2) - ₹8000 (20% OFF)USUI REIKI HEALER (LEVEL-1) - ₹4000USUI REIKI ADVANCE HEALER (LEVEL-2) - ₹6000USUI REIKI MASTER HEALER (LEVEL-3) - ₹10000KARUNA REIKI HEALER - ₹10000USUI REIKI MASTER TEACHER (LEVEL-4) - ₹35000USUI REIKI GRAND MASTER (LEVEL-5) - ₹32000PAST LIFE TEACHER COURSE - ₹13000DOWSING COURSE (BASIC) - ₹9000CLINICAL HYPNOTHERAPIST COURSE - ₹13000OTHER

DATE OF CLASS

₹₹ ENERGY EXCHANGE METHODS ₹₹
---CASHUPI ID (usuireiki@kotak)GOOGLE PAY (9873029525)PHONEPE (9873029525)PAYTM (9873029525)BANK TRANSFER:- (A/C Name: RUPA BARANWAL) (A/C No.: 7113667281) (IFSC Code: KKBK0000811)FOR ANY PAYMENT RELATED ISSUE CALL 7011811526

FEES PAID (IN TOTAL)

SCREENSHOT OF PAYMENT
Attach the screenshot of online payment below or send it to the official Whatsapp number "9873029525" or on email id "workshop@usuireiki.in" for seat confirmation.