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Enrollment Questionnaire


I am delighted that you have decided to enrolled in the Natural Healing/Herbal Remedies Class.  Please fill out the enrollment form as fully as possible.  This information will be kept in the strictest confidence and will not be shared with anyone.  We will need a complete mailing address to mail your Herbal Kit to. Please remember to give us your correct email address.  That is where I will be sending your welcome letter and lessons.  You must be 18 years old to enroll.  After you fill out this form you will be taken to a paypal link where you can finish your tuition subscription.  

Wishing you a warm welcome!

Lady Halcyon Mists, HPS


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Full Name:

 

Email Address:

 

Phone Number:

 

Street Address:

 

City:

 

State:

 

Zip:

 

Country:

 

How Did You Hear About Us?

 

Are You 18 or Over?

Date of Birth:

Yes  No          

 

Method of Payment:

 

Questions or Comments:

 

 

After you submit your form, you will be redirected to the tuition payment page to submit your tuition fees for the Natural Healing/Herbal Remedies Class. 

 Please email LadyHalcyon@willowshollow for assistance should you have any trouble with the enrollment form or tuition payment process. 

* Payment plan option is available only to PayPal tuition subscribers.

2006 Copyright (c) Willow's Hollow

Must be 18 years or older


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