Rukha Academy of Healing Arts and Science

Personal Information
First Name:*
Middle Initial:
Last Name:*
Name you would like on your nametag, if different than name listed:*
Address:*
Address 2
City:*
State:*
Zip:*
Date of Birth:*
Email:*
Phone:*
Phone #2:
Indicate the highest level of education completed and degrees obtained:*

high school college graduate doctoral other
If Other, indicate degree obtained
Occupation:
Tuition & Refund Information
Before submitting, print a copy of this application and send it along with your non-refundable $100 application fee and $500 deposit to:
Rukha Academy
c/o Healing Professionals LLC
PO Box 44878
Eden Prairie, MN 55344

If you for any reason decide not to attend, your deposit will be fully refunded according to the MN Buyer’s Right to Cancel.
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Personal Information