APPLICATION FORM:

 

PELVIC CORRECTION & YUAN SHI DIAN CERTIFIED COURSE

All Saturdays: on 13th June, the 27th  June and the 11th  July, 2020

FULL NAME:  .....................................................................................

FULL ADDRESS: ................................................................................

LAND-LINE: .........................................................

MOBILE: .............................................................

EMAIL ADD: ........................................................

OCCUPATION: .................................................................................................................................

THERAPY PRACTICED: ...................................................................................................................

SELECT:

COSTS: £160 per Workshop. Total of 3 Workshops: £480...................................................................
FULL PAYMENT OF £480.00 to be received by 1st June....................................................................
OR DEPOSIT OF £250.00 to be received by 1st June, balance to be paid on the day..........................
PAYMENT OF £450 (early-bird) if received before 15th May...............................................................

Bank Transfer Data:

Mr B Alexander:  Account number: 17348787.  Sort Code: 23 05 80

 

Kindly give your reference when credit transferring , as with your name, but also
an email message to:  alexalign.uk@gmail.com   indicating payment, and with your details as set-out above please.

 

 

AWA