Name * First Name Last Name DOB MM DD YYYY Gender Male Female Non defined Prefer not to say Ethnicity (how you regard yourself). Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Email How did you hear about this course? Have you done any other training with us? Special learning requirements Please inform us of any special learning requirements you have so we can adapt the course delivery to suite your needs the best we can. None English as second language Dyslexia Audio impairment Visual impairment Physical impairment Other If you have clicked other please give us more details here. Please provide us with some details about your massaging experience and qualifications Please tell us a little bit about your purpose in doing this course. It doesn’t have to be a Grand Plan - just an idea of what your aims might be. Please Check your preferred location of study Nelson Christchurch Palmerston North Bay of Plenty Birkenhead, Auckland Avondale, Auckland Otago Thank you! Once you have been assigned a tutor, you will be contacted about booking and deposit requirements. We look forward to working with you soon. Deep Tissue Massage Registration form Once you are assigned a tutor, you will be contacted about your booking and deposit requirements.
