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  • OA Hyannis

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    This document is an application for an Oneness Awakening Course taking place on October 12-13, 2013 in Hyannis, MA. It requests the applicant's contact information and answers to screening questions about their mental health history, substance use, and prior Oneness Blessing experience. The course fees are $195 before October 4th or $215 after, or $125 for those bringing a new person, with checks payable to Susi Bertini.

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    Oneness Awakening, Hyannis, MA

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    This document is an application for an Oneness Awakening Course taking place on October 12-13, 2013 in Hyannis, MA. It requests the applicant's contact information and answers to screening questions about their mental health history, substance use, and prior Oneness Blessing experience. The course fees are $195 before October 4th or $215 after, or $125 for those bringing a new person, with checks payable to Susi Bertini.

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    15 views2 pages

    OA Hyannis

    Uploaded by

    CapeCodOne
    This document is an application for an Oneness Awakening Course taking place on October 12-13, 2013 in Hyannis, MA. It requests the applicant's contact information and answers to screening questions about their mental health history, substance use, and prior Oneness Blessing experience. The course fees are $195 before October 4th or $215 after, or $125 for those bringing a new person, with checks payable to Susi Bertini.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    Oneness Awakening Course Application

    Applicants name: Street Address: City: Home Phone: Cell Phone: E-mail Address: Course dates: October 12 & 13, 2013 Course Location: Hyannis, MA Course Fee:(Please check) ____$195 (paid by October 4th) ____$215 (after October 4th) ____$125 (Blessing Givers only) ____Free to Oneness Blessing givers who bring someone new: Name of Person:__________________________ Please make check payable to: Susi Bertini and mail to: 21 Silver Lane, Hyannis, MA 02601 1. Have you received the Oneness Blessing?____ 2. How did you hear about this course? 3. Are you currently using or have you used within the last six months any medications for any mental health problems?____ 4.Have you ever been institutionalized for a mental health problem?____ 5.Have you ever been diagnosed with a mental health problem?____ If so, please describe the problem: 6. Are you challenged by any substance dependence or abuse? If so, which substances and how regularly do you use them? I hereby state that all my answers to the questions contained in this application are true, accurate and complete. _________________________________ Applicant's Signature For any questions concerning the course or application, please e-mail Susi @ sprashanti@yahoo.com State: Zip Code:

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