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0800 2 SUCCEED

0800 2 782 233

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Enrolment

Workshop Registration

 OTHER STUDENTS:
Full Name (please print):   
Address:                                                                                 
Phone:                                                      Mobile:
Email:  
Workshop Name Date Investment
     
     
     
     
  TOTAL  
Payment Options
 I enclose $ .................... deposit / full investment.   Note: Full fee only on Time Payment option.
I am making my payment made by:
  Cash / Cheque / Bank Draft - Make payable to ALPHA TRUST 
  Internet Banking - A/c Name: Alpha Trust. A/c Number: 010194 - 0070700-00
  Credit Card - Visa __ Master Card __ Tick one, and complete card details below:
Card Number:  
Card Holder's Name:  
Expiry Date: __ /__     Card Holder's Signature:
 

If for any reason the workshop is postponed  or cancelled within 14 days of regsitration you are entitled to a refund. After that date your payment can be credited towards a workshop at a later date.

Signature: ____________________________________________ Date: _____________________
 

Please print out and complete this form and post to:
 
Alpha Hypnosis
PO Box 104122
Lincoln North
Auckland
0654

Any queries?  Please contact us by phone 0800 2 SUCCEED (0800 278 2233) or email us

 

 

 

Contact Us...

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09 - 8377877
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Clinic 180 Lincoln Road
Henderson
Post PO Box 104122
Auckland 0654
Roger Saxelby - Registered Hypnotherapist and Master Hypnotherapy Trainer

Roger Saxelby

IACT Master Trainer, NZHRB Registered Hypnotherapist

Honorary Life Member NZHA & NZAPH. Life Member AHA (Aus) Dip. Psychotherapy & Hypnotherapy. (NZ) Dip. Adv. Hyp. (Aust & USA) Master Trainer IACT (USA),  NZQA Trained  Hypnotherapy Assessor .Cert. NLP Practi. Time Line Therapist, Cert. Member NGH (USA), NZHRB Registered Hypnotherapist, MNZCHP. .  Read more about Roger
Honorary Life Members - NZ Assoc Professional Hypnotherapists   Alpha Hypnosis Member of NZ Hypnotherapy Federation Inc.  
Roger Saxelby Life Member Australian Hypnotherapy Assoc.
  Roger Saxelby Master Hypnotherapy Trainer IACT   Roger Saxelby Member NGH (USA) 20+ years   Registered Hypnotherapsits NZHRB