STAR Tech Healing and Learning Center
Training Workshops for Massage Therapists and Bodyworkers
  
Advanced Training Registration
Download and print this form to register for a Professional Training STAR Tech® Workshop.
Mail the completed Registration Form with full payment or with a deposit.

Workshop(s) I plan to take

 Date Cost
  STAR Tech Treatments for Arms, Hands and Lateral Shoulders,    
            Level 1		 July 19, 2008
  STAR Tech Treatments for Neck and Medial Shoulders, Level 1 July 20, 2008
  STAR Tech Treatments for Knees, Lower Legs and Feet, Level 1 Aug. 9, 2008  
  STAR Tech Treatments for Back, Hips and Upper Legs, Level 1   Aug. 10, 2008  

  *Please Double Check for Possible Discounts     
             Workshop Total   

   $

Deposit     

   $

Balance Due Day of Workshop    

   $

 Please make check payable to: Barry L. Bailey
     Mail to: STAR Tech Healing  and Learning Center, 14 Nason Street, Suite 202, Maynard, MA 01754

Name: _____________________________________________________________

Address: ___________________________________________________________

Telephone: Home: _________________ Work: ___________________

E mail:  ___________________________________________________
I am a
 ____ Massage Therapist; ____ Physical Therapist; ____ Chiropractor;
 ____ Fitness Trainer; ____ Coach; ____ Student; ____ Other
Certification of Completion
 ____ I do want, ___ I do not want a Certificate of Completion for the Workshop(s) I am attending.
On my Certificate of Completion, please show my name as:

___________________________________________________________ (please print clearly or type)

I learned of these Workshops from: ___ Newspaper, ___ Magazine, ___Poster, ___ Internet,

____ e-mail,____ Brochure, ___ Friend or Co-worker, ___ Previous Workshop,

___ Other – Please Name the Source ________________________________

                                                                                                                                        Revised 5-5-08

Training Workshops