ENROLLMENT FORM | 4-WEEK TUITION FREE COURSE ON BRAIN OPTIMIZATION™ WITH EMPHASIS IN NUTRITION -- FLIP-LEARNING

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Dear Student:

Please take a moment to complete this very simple enrollment form (it takes about two minutes.) It will allow us to communicate with you effectively and give you access to BOI's 4 Week Course on Brain Optimization™ with Emphasis in Nutrition.

Brain Optimization™ Institute
Contact: Gian@BrainOptimziation.com

4-WEEK TUITION FREE COURSE ON BRAIN OPTIMIZATION™ WITH EMPHASIS IN NUTRITION -- FLIP-LEARNING FORMAT

I AM ENROLLING NOW *

4-WEEK TUITION FREE COURSE ON BRAIN OPTIMIZATION™ WITH EMPHASIS IN NUTRITION -- FLIP-LEARNING FORMAT

Required

IN THE FUTURE I WOULD ALSO LIKE TO LEARN ABOUT *

Wellness / Life Coaching with Emphasis in Cognitive Psychology

Psychology of Consciousness with Emphasis in Non-Duality

How to Create a Private Practice

BOI's Holistic Life Master Certification

The Awakening Protocol -- I would like to wake up to my True Self

Other:

Required

CONTACT INFORMATION

So we may contact you with an enrollment confirmation and give you access to the classes and tests

First Name *

Last Name *

email *

To send reservation confirmation to

Phone *

State *

Country *

For our international students taking the course online

WE VALUE YOUR OPINION

Please help us to do a better job at reaching our future students.

How Many Years Ago Were You Born

How Did You First Learn About Us *

You received an email invitation from the Brain Optimization Institute

You received an email invitation from Brent Philips

You received an email invitation from Marketing Yoga.net

You received an email invitation from Debra's Newsletter

You received an email invitation from Hawaii Health Guide

You received an email invitation from Jim Dreaver

You received an email invitation from HearBeat of Kaua'i MuseLetter

A friend -- you may name him of her in the comment section below if you want

Roy's email List

Samuel's email list

Other:

PLEASE FEEL FREE TO INCLUDE BELOW YOUR COMMENTS AND FEEDBACK

Add your comments here. Let us know what you think.

THANK YOU FOR CHOOSING BOI

Thank you for taking the time to complete your application. We look forward to welcoming you to BOI 4-Week Tuition Free Course in Brain Optimization™ with Emphasis in Nutrition. We will contact you soon.

A T T E N T I O N ! ! !

AFTER PRESSING 'SUBMIT' PLEASE SCROLL UP TO THE TOP OF THIS PAGE TO CONFIRM THE SUBMISSION OF THIS FORM.

Please allow three business days to receive your confirmation letter. If after three business days you have not received it -- emails can be lost in cyberspace -- please contact us at Gian@BrainOptimization.com or at 310-455-6815 -- Thank you.

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