Registration

Register for your courses by completing and submitting the form below.

    Enter your name exactly as you want it printed on your certificate, including initials (PhD, LISW, etc.):

    Please list the class level(s) you are registering for:
    Date/location:
    Date/location:
    Date/location:

    Contact Information:
    Address Line 1:
    City and State:
    Zipcode:
    Country (if outside US): [text*country]
    Home Phone:
    Office Phone:
    Cell phone:
    Email:

    Healing Practice:
    Type of healing practice you have:

    Payment Information:
    Eligible for Earlybird or Extra-earlybird rate?
    (if not eligible for the early bird or extra early bird rates, do not check this box.)

    Type of payment:
    Paypal*Personal Check or Money Order

    *Return to the course page for Paypal buttons to submit payment, or send Paypal payments to Dr. Stone’s account at contact@souldetective.net

    Checks/Money Orders can be sent to:
    Barbara Stone, PhD
    1817 State Route 83, Unit 513
    Millersburg, OH 44654