Space in this study is limited. If you have any doubt about being able to complete the study within twelve weeks, please sign up at a later, more convenient time.

 

Golden Key Course Application

Reply by E-mail - Fax - Regular Mail

Last Name:

First Name:

 

Street Address:

City:

State:

Zip

What Country are you located in?

Email Address:

Daytime Phone:

Evening Phone:

 

 

Occupation:

 

 

 

Church Affiliation if any:

 

 

 

Schools / Colleges Attended.
List dates, degrees


Why did you choose to study Emmet Fox?

 

 

Previous Education in Christian Metaphysics.
List dates, schools, recognition, experience

 

 

 

Education Goals:

 

Personal Enrichment
Teacher - Other

 

Class Title:  Fundamental Course

The next Class will be held in September. A $20.00 non-refundable deposit must accompany application.

 

 

Total Amount $140.00   (Including Registration Fee)         

 

Note:  The $20.00 Registration can be paid via paypal. PAYMENT LINK IS ON THE CLASS INFORMATION PAGE
 
Payable by check to:   Rev. J. Corsiatto

 

___________________________________________ Date ________________________

Signature

 

Please enclose check and mail together with this form to:

Rev. J. Corsiatto
P.O. Box 21
Farmingdale, New York 11735

Payments Options, Please indicate your agreed payment plan.

Initial $20.00 Registration Fee is NOT refundable.   (Full payment in advance in the amount of $140.00 for the lessons and registration fee, is recommended but not mandatory.) The cost of each individual lesson is $15.00. Each lesson would then be paid via paypal, or Master card/Visa. To avoid additional record keeping, we cannot accept separate checks for each lesson. Checks for full payment are acceptable.

 Method of payment (Check one)  Paypal___  Master Card/ Visa ____  Full Payment ____

Please call or fax your charge card information including Ex date to 516 753-0191

 

 

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