Thai Bodywork Course Registration Please complete this form to register for a course. Name for your certificate* First Last Address Street Address City State / Province / Region ZIP / Postal Code License number and state Email* Phone*Please indicate course location and dates you are registering for*Payment MethodI will mail a check.I will pay by credit card. Please send me PayPal link.How did you hear about this course? PERG magazine ad Web search Postcard Referral CE Broker Have you taken one of Robert's classes previously? Yes No CAPTCHANameThis field is for validation purposes and should be left unchanged.
