Alice Konyves, Mind Your SpiritTM, Contact Information

Register

1. Silva Life System Seminar (Application Form)
2. Silva UltraMind ESP Seminar (Application Form)

Silva Grad Certificate Number

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Date of Birth:

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Dates you wish to attend

How did you learn about the Silva Method?

Check four or more benefits you'd most like to gain from the Silva Method Course

Learn to relax	Set and achieve goals	Learn creative problem solving
Improve health	Salesmanship	Find your life's work
Overcome insomnia	Stop headaches	Develop a positive attitude
Reduce stress	Find your soulmate	Improve memory and concentration
Reduce weight	Eliminate non-productive habits	Change limiting beliefs
Stop smoking	Free yourself from worry	Improve personal realtionships
Develop confidence	Create prosperity	Awaken intuition & creativity

Today's Date

Have you been treated for :
Mental Disorder Seizure Disorder Fainting Spells
If you are or have ever been under a doctor's care for the above conditions, you can attend the seminar with the express written permission of your doctor.

Once you've decided to attend, submit the form (or print using "print" button on browser) and mail payment two weeks prior to the seminar. I have to reserve the presentation space with sufficient advanced notice. Thank you very much.

Mail Payment to:

Alice M. Konyves, CSMI, CI, ACH
259 Mill Street
Westwood, New Jersey 07675