Renascent College of Intuitive
Sciences
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143 Research - Warrandyte
Rd, Warrandyte, 3113
Ph: 03 9844 5888 Fax 03 9844 2788
Diploma & Certificate
Application Form
I hereby apply
for the below indicated certificate (s) / Diploma (s). Please fill in date of each course
completed & enclose photocopies of certificates achieved for each.
When completed mail to the above
address. Please
post to me/ I will pick up
Complete Correct Spelling of
Your Name
……………………………………………………………………………
Address to be sent to
…………………………………………………………………………………………………..
Phone
………………………………….
Email:
…………………………………………………………………….
Please note: Top & Bottom of
form must be filled in & signed
PROFESSIONAL
PRACTITIONER & CERTIFICATION LEVELS
Certificate of Reiki
Professional Practitioner
Reiki
1 Date: …………. Reiki
2 Date: …………. Reiki
3 Date: ………….
Reiki
Masters Date: ………….
If completed prior to 2004 - Reiki Linking Seminar Date:
………….
Certificate of Reiki 1 & 2 Teacher
Certificate
of Reiki Professional Practitioner Date: ………….
Usui
Reiki Instructor Training (formerly Advanced) Date: …………….
Certificate of Dou
jou Reiki Professional Practitioner
Dou
jou Reiki 1 Date: …………. Dou
jou Reiki 2 Date: …………. Dou
jou Reiki 3 Date: ………….
Dou
jou Reiki Masters Date: ………….
Diploma of Reiki
Certificate
of Reiki Professional Practitioner Date: ………….
Certificate
of Dou jou Reiki Professional Practitioner Date: ………….
(*Please
note bi yearly Update & Assessment required to maintain status in
master classes) |
Certificate of Natural Health Sciences
Reiki
1 Date: …………….
BK (TFH) 1 Date:
…………. BK 2 Date:
…………. BK 3 Date:
…………. Crystal Light
Balancing Date: …………….
Qi Gong 1 Date: …………. Qi Gong 2 Date:
………….
Geomancy
Date: …………….
Stellar Essences Date:
…………….
Houses of Life Date:
…………….
EMF
& Chi Products Date: ……... Gem
Essence Course Date: ……… Crystal Workshop Date:
……………. |
Diploma
of Natural Health Sciences
Certificate
of Natural Health Sciences Date: ……………. ARC
Course: Date: ………….
Qi
Gong 3 Date: …………. Qi
Gong Masters Date: ………….
Reiki 2 Date: ………….
Reiki
3 Date: …….. Reiki
Masters Date: …………. If completed prior to 2004 - Reiki Linking
Seminar Date: ………….
(*Please
note 1 bi yearly Update required to maintain status in master classes)
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Certificate of Basic Kinesiology
Basic
Kinesiology 1, 2, 3, (or TFH 1-4) Dates: ……….…../ …….……../
…….……../ …….……../
60
Hrs optional study courses – Please list classes & Dates:
………………………………………….
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
(Maximum
hours at this level = 10 from healing circle (prior to 2003) or 10 from Qi Gong
Cultivation (from 2003 onwards) & 5 hrs from repeats) |
Optional
study courses & hrs accredited per course:
EMF
& Chi products (4), Perceptive Vision (4), Food & Supplement Workshop (4),
Practical Anatomy (16), Stellar Essences (8), Houses of Life (8), Crystal Light Balancing
(8), Healing Circle (1.5hrs per class), Tibetan Energy (4), Basic Anatomy (8), Geomancy
– Earth Energies (8), Gem Essence Course (16), Practice Nights (2.5 per eve’),
Qi Gong Cultivation (1 hr per class – from 2003 onwards), Repeats (50% of course hrs
– TFH classes = 10 hrs repeats per class), ARC Course (32), Qi Gong 1-3 (16hrs each
level) |
Certificate
of Professional Kinesiology Consultant
Certificate
of Basic Kinesiology Consultant Date: …………….
Qi
Gong Kinesiology Date: …………….
Essences
in Practice Date: ……………
120 Hrs optional study courses (Including 60 achieved at
Certificate of Basic Kinesiology level) – Please list classes & Dates:
………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
Must
Include:
Practical Anatomy Date………… ….. An Essence Course Date:
……………………
(Maximum hours at this level = 20 from
healing circle or 20 from Qi Gong Cultivation & + 10 hrs from repeats) |
Certificate of Feng Shui & Geomancy
Feng
Shui 1- The Beginning Date: ……………. Feng Shui 2- Building On Date:
…………….
Level
1 Consultancy Date: …………….
EMF & Chi Products Date:
…………….
Geomancy
– Earth Energies Date: ……………. Houses of Life – FS Vibrational
Medicine Date: …………….
2
Home & / or Business reports Date: ……………. |
Professional Feng Shui & Geomancy
Consultant
Certificate
of Feng Shui & Geomancy Date: ……………. Professional Feng Shui Date:
…………….
Advanced
Geomancy – Earth Energies Date: ……………. Chinese Astrology Date:
…………….
Level
2 Consultancy Date: …………….
2 Home & / or Business reports Date:
……………. |
Diploma of Feng Shui & Geomancy
Certificate
of Professional Feng Shui & Geomancy Consultant Date:
…………….
Destiny
Analysis & Lopan Date: ……………. Tien Ti Masters Date:
…………….
Qi
Gong 1 Date: ………….
Qi Gong 2 Date: …………. Qi Gong 3 Date:
………….
Qi
Gong Masters Date: …………….
2
Home & / or Business reports Date: ……………. |
Please Note: Since you commenced
studies, diploma /certificate levels may have changed. You can use the current
specifications or those that were current in the year you commenced studies.
For further class
info – Please refer to the current prospectus (call to have 1 sent) or the website
Thank you for
studying with us – we hope you have gained many valuable skills & we look forward
to awarding your certificate(s) / Diploma(s) to you.
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I
certify that I have completed the above listed courses personally with The International
College of Intuitive Sciences & / or Renascent (exemptions
may be available for study completed elsewhere – please speak with us personally
regarding this matter).
Name:
………………………………………………..Signed: ……………………..……………
For further class
info – Please refer to the current prospectus (call to have 1 sent) or the website
Thank you for studying with us –
we hope you have gained many valuable skills & we look forward to awarding your
certificate(s) / Diploma(s) to you.
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