Address ______________________________________
City ____________________________________________State ______Zip________________
Phone __________________________Email ______________________
Explain reasons for becoming a holistic Apprentice _______________________________________________________________________________ ____________________________________________________________________________________________________________________________ ____________________________________________________________________________________________________________________________
Prioritize interests: ( 1-10)
Reiki____Yoga____ aromatherapy____herbs____gardening____
anatomy____nutrition____developing intuition____flower essences____
other (specify) ______________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________
Additional questions or comments: ____________________________________________________________________________________________ ___________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________
Please attach brief personal history or biography along with this printed form and mail to:
Linda Green, PO Box 622, Port Clinton, Ohio 43452, (419) 635-2337