Thai Massage Sacred Bodywork - Student Application Form

INTRODUCING

Thai Massage Sacred Bodywork Training Application

To reserve your place in class, please complete and submit this form. Once your completed registration form and course fee have been received, a place will be reserved for you. * denotes required fields.

Level applying for*
First Name*
Last Name*
Address*
City*
State*
Zip Code*
Home No.
Work No.
Cell No.
E-mail*
Date of Birth (mm/dd/yy)*
Age*
Professional Background*
Current Physical Problems*
Previous Physical Problems*
Surgeries*
Medications*
Have you ever had a Thai Massage before?*
Have you studied Thai Massage before? If so, with whom? *
How did you hear about Thai Massage, Sacred Bodywork?*
Comments or Questions*

Thai Massage
Sacred Bodywork

PO Box 231532
New York, NY 10023
ananda@thaimassagesacredbodywork.com

It's a Stretch!
Thai massage is getting more patients off the table.

August 30, 2004 TIME article featuring Ananda doing Thai massage.