Introductory Evening Seat Reservation - Become a Certified Hypnotist - January 4

  Please reserve a seat for me at the Introduction to your NGH Hypnotist Certification Class - January 4th from 7PM to 8:30 at the Barrington Library Trustee Room. 

 
1.
Please enter the information indicated below.

First Name:
Last Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
City:
State/Province
(US/Canada):
Postal Code:

2.

What is the best day, time and number for me to call if I have to reach you? 

 

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3.
I heard about this program:
From your webpage
From The Barrington Times Article
From a friend or associate
An print advertisement
An advertisement or posting on facebook
Other  
  • Comment:

  • 500 characters left.
4.
Please indicate your experience with hypnosis.
Never been hypnotized
Hypnotized once (or a few times) for a single issue like quitting smoking
Hypnotized multiple times for various issues
One of your clients (or former clients)
Have been practicing hypnosis as an amateur
Long-term practitioner or self-hypnosis
Other  
  • Comment:

  • 500 characters left.
5.
How might you use this training and certification?
Full-time career
Part-time business
Adjunct to another practice (mental health counselor, energy worker, massage therapist, etc)
Personal growth (not professional)
Not sure yet
Other  
  • Comment:

  • 500 characters left.