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EMC: About Self Healing Energetic Balancing
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   Aim Information Kit
      

Fill out the form below and receive our AIM Energetic Balancing Welcome Kit absolutely free! This Kit will include everything you will need to enroll in the AIM program including AIM applications and a 30 minute question and answer audio CD about our program. Once we receive your information, we will refer you to an Independent EMC² Facilitator assigned to your area. EMC² Facilitators help provide information and support to people who enroll in the AIM Program.

EMC² never shares your contact information with others outside our organization. We do not send any information to you without your permission. You may withdraw your permission at any time.

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         Email:  Required
First Name: Required
Middle Name:
Last Name: Required
  Gender:   Male Female

If you are requesting information and are not already or previously an AIM Program participant, we need your mailing address to send you our information packet and free CD.

  Address: Required
                      
         City:  Required
      State:      
Zip Code: Required
   Country:    
Primary Phone: Required  
 Alternate Phone:   
                       Fax:   

Best time to reach you:

I'm interested in AIM, but not yet on the AIM program.
I'm currently involved in the AIM program.
I was previously involved in the AIM program.

My EMC² ID code is/was:

It's okay to send me information by e-mail.
It's okay to send me information by regular mail.

How did you hear about the AIM program? Required
if Other, please specify:

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EMC²
Las Vegas, Nevada
info@energeticmatrix.com
1-877-500-EMC2 (3622)

To contact EMC², e-mail us at info@energeticmatrix.com

 
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