A Path to Healing l & ll

Class Date(s):___________________________

 Name: (as you want it to appear on your certificate:(Please print:_______________________________________________

Email:_______________________________________________

Phone:_______________________________________________

 Address:_____________________________________________

City:_____________________State:__________Zip:___________

CEU Certificate Required? Yes /No (circle) Massage Therapist Only

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PAYMENT RECORD:

Date:

Amt. Received:

Balance:

Discounts:(Type and Amt.)____________________________________

Signature:_______________________Date:_____________________

Comments/Notes:

The cost is $350 for both classes, or $175 each. Cost includes a student handbook. Sign up 30 days before class with a deposit of $150 for both classes and receive a discount of $15.00 for each class. The deposit ins non-refundable but is transferable. Any balance must be paid in full at least 15 days prior to the class commencement. Classes will be held at A Path to Healing 2832 Main St., Ingleside, Tx. 78362.

For questions, please call Linda Miller at (361) 676-2506.