Courses Application Form

Please fill out all the information below

My Information

a

Hotel Information

Questions to Answers

  1. Do you need a translator
  2. Language needed
    if you need translator
    (additional charge will apply)
  3. I am taking this class for :
  4. I am a massage practitioner and
  5. I have studied: Please mark each modality and write in other areas of study
  6. for (weeks/months/years)
    for (weeks/months/years)
    for (weeks/months/years)
    for (weeks/months/years)
    for (weeks/months/years)
    for (weeks/months/years)
    for (weeks/months/years)
    for (weeks/months/years)
    for (weeks/months/years)
    for (weeks/months/years)

I want to Register for workshop:


details

days

Please retype the letter,
so we can process your reservation

Please Reserve 3 days before and confirm your booking
on arrival in Bali by phone (0361) 778 084