| Course name: | |
| First name: | |
| Last name: | |
| Your name as you would like it to appear on Certificates/Diplomas. |
Please indicate designations (CMT, LMT, RYT, RN, etc) |
| Cell Phone: | |
| Home Phone: | |
| Work Phone: | |
| Email address: | |
| Mailing Address: | |
| City: | |
| | State: Zip Code: |
| Birthdate: | |
| Occupation: | |
| Emergency contact person: | |
| Phone: | |
| How did you first hear about Thai Massage? | |
| What first drew you to Thai Massage-what intrigued, inspired, and peaked your interest about this healing art? | |
| What are your goals in learning Thai Massage? |
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| What is your previous background with the healing arts-bodywork, yoga, acupuncture, herbs, etc? | |
| What do you plan to do with this training? | |
| Please name a strange, quirky thing about yourself that makes you unique. (For example: "I am the milk-smeller of the family") | |
A deposit is required to reserve a place in our intimate, training experience (10 students maximum).
Your deposit for each training and for the "Bundle and Save" packages is non-refundable should you cancel out of your selected workshop when scheduled workshop takes place. We will refund 100% of the deposit for any canceled training that is due to our responsibility. When buying airfare, we suggest using Southwest airlines when possible as they don't have a penalty for changing reservations.
Please submit payment via the payment buttons on each training page.
You can also mail a check or money order to:
Textured Motion, Inc
2812 Umatilla St.
Denver, CO 80211 |
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