registration form Name * First Name Last Name Course Name * Course Start Date * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone Number Have you studied Massage Therapy before? Yes No If yes, to what level have you studied Massage Therapy? Cert IV Massage Therapy Diploma of Remedial Massage Short Courses only Which Massage Association are you a member of? What inspired you to study Thai Massage? * Have you ever studied Thai Massage? Yes No If so, Where did you study? How long was your training? * How did you hear about this course? * Do you have any learning difficulties? * Yes No If Yes, how can I help you absorb the teachings more easily? Do you have any health issues / injuries / mobility problems that may affect your ability to perform a Thai Massage? * How will you secure your place in this course? * Pay in Full Deposit Thank you for registering for your upcoming course. I am excited to sharing this wonderful healing art with you soon.
