TRE - Reiki Student Registration Form

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This form is only for "The Reiki Expert" students to register themselves for their training during the Reiki training seminars conducted by Reiki Usui Grand Master Rakshak M. Bhansali. If you have any questions from or while filling in this form, please call/contact us at +1 (630) 923-4115. Thank you and look forward to seeing you soon in our upcoming Reiki training seminar!

Email *

Student's Full Name *

Student's Home Address *

Student's Birth Date *

YYYY

Student's Emergency Contact Information (Name, Phone Number, Email ID) *

Student's Exact Name That Must Be Shown In The Reiki Training Completion Certificate *

Please make sure to write this name very carefully and accurately as we will use the exact same name and spelling in your Reiki certificates upon fully and successfully completing your Reiki training for a given level for which you are registering now.

Student's email ID *

Student's Phone Number *

Please provide your full phone number using + sign followed by your country code followed by your local phone number. For example, +1 (630) 923-4115 for the USA.

Reiki Level Training For Which Student Is Registering (Select All That Apply If You Are Registering For a Bundled Offering). *

Reiki Level 1

Reiki Level 2

Reiki Level 3A

Reiki Level 3B

Reiki Grand Master

Required

Date of The First Reiki Training For Which Student Is Registering *

YYYY

Date of The Second Reiki Training For Which Student Is Registering (Use this only of the student is registering for a bundled offering that combines training for multiple levels) *

YYYY

Have You Ever Learned Reiki At Any Level Before? *

Yes

Reiki Level 1

Reiki Level 2

Reiki Level 3A or Reiki Master (but not Teacher)

Row 1

Does The Student Have ANY Health Condition That REQUIRES Any Special Attention / Accommodation During Reiki Training Seminar? *

Yes

Describe Here The Students' Special Attention / Accommodation Needed During Reiki Training Seminar

How Have You Heard About This Reiki Training Seminar? (Select all that apply). *

"The Reiki Expert" Google My Business Page

"The Reiki Expert" web site

"The Reiki Expert" Flyer That I Got From Somewhere

From Google Maps

From Bartlett Chamber of Commerce web site

From a Client or Student of "The Reiki Expert"

I am a Client of "The Reiki Expert"

I am a Student of "The Reiki Expert"

Other:

Required

What Are Your Expectations At The End of Completing This Training? *

Help us avoid spamming *

To ensure this form is not filled in by bots, please answer below the total of 3+2 = ?

Send me a copy of my responses.

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