HOLISTIC STUDIES INSTITUTE
REGISTRATION FORM
Welcome to our registration page. Just print and fill out the application and send or fax to use at your convenience.
Psychic Development Program
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Instructions: Important: Please read our Terms and Policies (below) BEFORE submitting your application. Be sure to sign the application indicating your agreement to comply with our Terms and Policies. T o register by mail, print this form, below, fill it out and circle the class for which you are registering. Mail it in to our main office in Albany with either your credit card information or a check or money order payable to "Holistic Studies Institute."1510 Central Avenue --Suite 375 Albany, NY 12205 For Weekend Psychic Development Levels I - III Payment: Each application for enrollment most be accompanied by the check or credit card for the full payment for each weekend class in the amount of $230. This amount constitutes your commitment to take the course. $230 -- Total tuition per weekend if student is enrolled by paying the application fee no later than the Friday immediately preceding the Saturday start day of the class. $260 -- Total tuition if not pre-enrolled--for walk-ins. $115 -- Total tuition for students who wish to REPEAT any weekend course. No application for enrollment is accepted without the required tuition fee attached to it. Partial payments are not accepted. Third party checks are not accepted. There is a $25 fee on all returned checks. If your check is returned from your bank, future payments must be made by credit card only. Mail to:
Register by fax (with credit card)
Register by phone (with credit card) Registration questions? Office Hours: Monday
- Friday 3 - 8 PM. Please call us during office hours.
At all other times please leave a message on our voicemail. Cathy Patierno, HSI
Office Manager will be happy to return
your call during office hours. Cathy Patierno, Office Manager, at HSI's Main Office |
Registration Application for 2012
Print this application and send or fax with tuition payment. You may fax this application with credit card information or mail with check to the above address.
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APPLICATION - 2012 |
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PLEASE PRINT AND SEND TUITION FEE NO LATER THAN 5 DAYS BEFORE CLASS BEGINS. |
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Name |
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Address Apt # |
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| City: State Zip | ||||
| Home Phone: | ||||
| Work Phone | ||||
| Cell Phone | ||||
| Email address: | ||||
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Enrollment Information Please write in the course in which you are enrolling |
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| Course Level: Course Part (ie., Part I, II or III): | ||||
| Date of the course: | ||||
| Select the course in which you are registering (above), mail fax or call this form into our office. For FAX enrollments please provide the following: | ||||
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Credit Card Number: |
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Exp. Date ____/____ |
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| Signature Date___/____/____ | ||||
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* For all Psychic Development Weekend Courses full tuition of $230 is due BEFORE courses begin. |
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| Other information: | ||||
| Your Astrological sign: Birthday: ____/_____/_____ | ||||
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Please briefly list other holistic-type courses you have taken in the and list any certificates you've earned |
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Signature: |
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| Signature -- By signing above you are indicating you agree with HSI Terms and Policies as listed below. | ||||
| This application will not be accepted without your signature above and the required payment. | ||||
Pre-registration is required.
Just
print the application and fax or send to us. You may also call us and
we'll send you additional registration forms with an application..
Mail or fax the completed application tuition fee no later than five
days before class begins. Upon acceptance, you will receive a
confirmation letter or phone call. The tuition is due in advance for
all courses except the Circle of Light Course. (see above for specific amounts).

Discover, MasterCard, Visa, American Express, checks and cash are accepted for tuition.
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Terms &
Policies A full refund of the application fee and or tuition, which is paid in advance, is given to students who notify HSI of their intent to drop the course within 24 hours of the starting date. If HSI is not informed of your intent to drop the course within 24 hours of the starting date, no refund will be given. However, a credit will be indefinitely kept on file for the amount you paid. This credit may be applied toward future classes which you may take. No refund will be given otherwise. Additionally no refunds are given to students once they have taken the course, regardless of attendance, or their displeasure with the course or the instructor or for any other reason. HSI reserves the right to change the date, cancel or reschedule a class, in which case, students who are not able to attend the class because of said change are entitled to a full refund of tuition paid. HSI is not responsible for any reimbursement of your time, your travel expenses, including lodging, costs of baby sitters or any other expenses you may have incurred, in any way, related either directly or indirectly to enrollment in any of our courses. HSI reserves the right to refuse enrollment to any individual whom it determines to be unfit, unready or otherwise incapable of making a positive contribution as a participant in of any of our courses. |
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Welcome Policy HSI accepts students without regard to sex, handicap, disability, race, age, color, religion, national or ethnic origin, marital status, or sexual or affectional preference. |