Workshop Information Request Form


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REQUEST Form for Certification in Open Focus™ Training
and/or Neurosynchrony Training Information

Please provide us with your personal information and the desired type of training, including requested dates for individualized Mini-Intensives. Once received, we will contact you by e-mail to finalize registration payment and arrangements for training.

PLEASE NOTE: THIS IS NOT A SEAT RESERVATION FOR THE OPEN FOCUS/BRAIN SYNCHRONY WORKSHOP. THIS IS AN INFORMATION REQUEST ONLY.
TO REGISTER FOR THE WORKSHOP, PLEASE CLICK HERE


Your name:
Your mailing address:
Your phone number:
Your e-mail address:
Professional Degree:
Interest in Certification for (please choose only one):

Training Preference:
Training Dates Requested ( Please indicate month and dates you are interested in for your training and certification.)

Referred by:

Visit our online store to order our products including downloadable MP3s.

Reserve your seat for the

OCTOBER 5th, 6th and 7th FALL OPEN FOCUS/BRAIN SYNCHRONY WORKSHOP

WEBINAR TROUBLESHOOTING

For difficulties connecting to the webinar seriesplease click the above link. Dr.Fehmi's staff does not have the ability to troubleshoot the connections.

PROMOTIONS

Subscribe to our email list and receive a free download of the Long Form Open Focus Exercise.


First Name *

Last Name

Email *

We value your privacy and will not share your information with anyone.