Advanced Invitational Therapeutic Touch Workshop Application

Please use this form to send your application for the Advanced Invitational Therapeutic Touch Workshop.

Personal Information

Name *

Address

Address 2

City

State

Zip code

Phone (Cell)

Phone (Home)

Email address

Housing Preference

Cabin/House

Dormitory

Tenting

Commuter

Profession

Professional License #

Licensing Body

Previous workshops

What are your major learning objectives in attending this year's workshop?:

Do you teach Therapeutic Touch? If yes, where and to whom?:

Are you interested in making a short presentation to the group? If yes, what topic?:

Additional comments