Booking Form
massage and reflexology school in the west midlands
I wish to book onto the following Course/Workshop:
Course Title:

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Course / Commencement Date:

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1. Contact details:
Full Name:
Name is required.
Address: Address is required.
Telephone/Mobile:
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Email:
Email Address is required.
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Present Occupation:
Qualifications:
Date of Birth:
Date of Birth is required.
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Do you have any disabilities or conditions which may require any special help during the course/workshop:
How did you hear about the course/workshop:
2. Declaration:
Declaration is required. I confirm that I have read and understood and am happy to accept the Booking Terms and Conditions (available by clicking here). Please note that a payment made via PayPal or Credit/Debit Card also forms acceptance of the Booking Terms and Conditions.
Signed: Name/signature required.
Print name:
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Date:
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3. Method of payment:
Credit/Debit Card (all major cards accepted) PayPal

Please state amount due:    £       
Deposit        Full amount (required for all individual courses/workshops)
To secure your place on a Programme: A deposit of £100.00 secures a place. The balance is then due no later than 30 days prior to commencement of the course. You can choose to spread the cost of the programme and pay by affordable monthly installments over the duration of your course and on an INTEREST FREE BASIS - click here to complete an Easy Payment Plan form and submit it with your booking.

If paying by Credit/Debit Card: Please telephone 0121 474 3414 to make your payment.
If paying by PayPal: Please ensure you state your PayPal transaction ID. Click on the PayPal button below to make your payment (A new window will open. For PayPal payment instructions click here).
Make a payment with PayPal

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Upon receipt of your payment and signed completed Booking Form,
we will send you a Confirmation and link to your Induction Pack.