Herbs, Healing and Magic:
A Correspondence Course
Name
Date of Birth
Address
Postcode
Telephone
Do you have any previous experience of working with herbs?
Do you have any allergies? If so, please list them here.
Do you have any medical conditions or take medications (including the contraceptive pill)? If yes, please give details here, as this may affect the herbs you can take internally.
Are you pregnant or likely to become pregnant during the course?
(If so, you will need to avoid taking many of the herbs internally.)
Please write a few paragraphs about why you would like to do this course and what you hope to achieve. (If filling in by hand, use the back of this form and/or a separate sheet if required. If filling in electronically, please expand this space.)
Please send your cheque for £150 to Val Thomas
at 45 Beatrice Road, Norwich NR1 4BB.