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Thai Massage...for Transformation, for Health, for Healing

 

To register for class, copy and fill out the form below, then email to Rose@thai-massage.org

Or  call ITM @ 609-390-1016 with registration and payment information

Or Mail the registration form below with a check or money order

(made payable to ITM-USA) to:  ITM-USA, PO Box 246, Marmora, NJ  08223

Balance due AT LEAST ONE MONTH before class starts. 

 


Registration Form

Yes! Register me for: ______________________________________
                                  (fill in class name, date, location).

Enclosed is full class fee of $_______
 or $100 deposit to hold my space.



Optional housing fees also enclosed of: ___ $250 Shared Room one week or $500 for two weeks

 

                                                        ___ $350 Private Room one week or $700 for two weeks

    OR for Review class only: ___ $60 Shared Room ($30/night x 2 nights)

                                                                    ___ $100 Private Room ($50/night x 2 nights)

Include a check or money order (made out to ITM-USA), or fill out information below to have your card billed directly :

credit card (Visa & MC only) # __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __

exp date __ __ / __ __        3 digits security code on the back on your card   __ __ __

Include your signature here  X_______________________________________________

billing address must match mailing address below

Name(s) : _______________________________________________

Mailing Address (STREET, CITY, STATE, ZIP):

                 _______________________________________________

                 _______________________________________________

Phone :     _______________________________________________

Email:       _______________________________________________

Thank you. We look forward to seeing you for this class!