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Complete the below application or download the application form by clicking HERE.

Applicant Information

What information do you want customers to see on the geneway website?

Second Practice address if applicable

Education & occupation

YOUR REQUIREMENTS & INTERESTS

DISCLAIMER AND SIGNATURE

I certify that my answers are true and complete to the best of my knowledge. I understand that it is at the sole discretion of GENEWAY TM to accept my application, or revoke my status as a GENEWAY TM Practitioner.