Registration Form

Institute of Heart Intelligence – Registration Form

Investment Super Early Bird
(28 day)
Includes food & accomodation
$2,970 $2,470 $100 discount per person
Certificate III LevelIncludes food and accomodation $5,700 $3,700
Personal Development Level
Includes food and accomodation for the 5 modules
$9,700 $7,770
Paid by 16 June
$500 discount
per person
Practitioner Level – Certificate III & IV Level
Includes food and accomodation for the 5 modules plusPractitioner Training days
$13,700 $10,770
Paid by 23 January
$500 discount
per person
Individual Modules

Circle to select:


Awakening Inner Child

Manhood & Womanhood


Radical Breakthroughs

Regular Fees


 Early Bird (paid in full 14 days prior to each module)


Early Bird price applies if fully paid four / two weeks prior to event. *^Group Bookings: 2 or more people bookings paid at the same time.

SPACE IS LIMITED – Fees are to payed in full 7 days prior to seminar. If cancelled less than 5 days prior to Seminar; fees are transferable, non-refundable. Late cancellations for seminars are virtually impossible to fill. Cancellations less than 7 days prior to seminars which leave a vacancy unfilled may be charged in full. Once a seminar starts, fees are non-refundable

Seminar Name: Phone:
Name(s): (h)
Mailing Address : (w)
Suburb Postcode (m)
Email Address:
Payment By: Visa / Master Card / Cheque
Cardholder’s Name
Credit Card Number
Amount Paid Signature Expiry Date

To Register: Phone, Post, Fax or Email this form to:The Institute of Heart Intelligence

P.O. Box 198. The Basin 3154 Ph 03 9739 8889 Fax 03 9739 8885