Massage TOOLS for Healthy Returns.
Registration Form.
January 7, 2017
Massage At Monroe , Monroe, NC 28110 704 221 5872
Name: __________________________Title:___________ License # ________
Street: ______________________________________City: _______________
State: _________Zip: ______________ Email: _________________________
Phones: (W) ____________________________(C)_______________________
January 7, 2017 8 hours $149 _______
Payment options:
1) Preferred method of payment: Check.
Make Check payable to Massage At Monroe and mail to:
Massage At Monroe, 2325 Hanover Dr, Monroe NC 28110.
2) Credit Card # _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Exp _ _ / _ _ 3 digit code on reverse _ _
_________________________________________________________
Signature (I agree to Grand Total charges above) Fax to 704 282 4683
For any additional questions or registration by phone please call Carmen at 704 221 5872.