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:
A Telephone Number is required.
Email:
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Present Occupation:
Qualifications:
Date of Birth:
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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: £ (full amount)
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).
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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.