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The Light & Sound Healing Ministry and Center

‘A Church Dedicated to Spiritual Healing & Lightworkers Around the World’

Dr. Tony Mulberg, M.S., D.C., Spiritual Director
8456 E. Loos Drive
Prescott Valley, AZ 86314 U.S.A.
TOLL-FREE Tel: (877) 946-2455 Fax: (928) 759-2694 E-mail: lightandsoundhm@earthlink.net

Churchmember and Spiritual Healer Application Form

 

FULL NAME: ___________________________________ DATE: ______________________

ADDRESS: ___________________________________________ APT: _________________

CITY: _______________________________ STATE: ________ ZIPCODE: _____________

COUNTRY: ______________________

TELEPHONE: (_______) __________________ FAX: (_______) _____________________

E-MAIL: ______________________________________________

PLEASE PROVIDE A BRIEF STATEMENT ABOUT YOUR SPIRITUAL HEALING WORK:

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

ARE YOU CERTIFIED OR LICENSED IN ANY FIELD OF THE HEALING ARTS? (CIRCLE) YES /NO

IF YES, PLEASE LIST THE TYPE AND STATE/COUNTRY OF AUTHORIZATION:

____________________________________________________________________________________________

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A ONE-TIME $20 MINIMUM DONATION IS REQUESTED WITH YOUR APPLICATION.

DO YOU WISH TO ENCLOSE AN ADDITIONAL DONATION TO OUR MINISTRY? (CIRCLE) YES / NO

IF YES, PLEASE INDICATE THE AMOUNT ENCLOSED: $_________________

I WANT TO ENROLL IN THE MINISTRY'S ONE-YEAR PREORDINATION HOME STUDY COURSE PREPARING ME FOR CLERIC ORDINATION IN THIS MINISTRY. PLEASE SEND ME THE FORMAL AGREEMENT. (CIRCLE ONE) YES / NO

For more information about the Preordination Program, click here.


Please print out the membership application and mail to the address listed at the top of the form.

 

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