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					          ISTRAT
       REGI          ORM F
               TION FO        ARRY’S CLASS ONLY
                         FOR LA          SES

                                               3)
                                            (973 263-2229
                                    www.newje
                                    w                age.com
                                            erseymassa




                                           ter: Mail o Fax: 97
                     Two easy ways to regist         or               22
                                                             73-402-122

 
  me_________
Nam                  ___________
            __________                   one (_____)_
                               ______  Pho                    _____  
                                                    ___________
   ress_______
Addr                  ___________
             __________                   __________
                                ___________                  _   
                                                   ___________
    __________
City_                    _____  State
               ___________                    _____  Zip __
                                    e _________                     _ 
                                                          ___________
 
E‐Ma           ___________
    ail Address_         __________ _____________________           ______ 
                                                          ___________
    you a gradua
Are y                                  Massage Tra
               ate of the North Jersey M                    er? ________
                                                 aining Cente          ______ 
 
Course Name                                                                     unt     ow
                                                                             Amou paid no
    mate – Core_
Ultim           _________________ Daate________
                                              __________
                                                       _$60 / Free               __________
                                                                             $____        ___
    mate Back __
Ultim           _________________ Daate________
                                              __________
                                                       _$175                     __________
                                                                             $____        ___
    mate Hip & L _______
Ultim          Leg        _______ Daate________
                                              __________
                                                       _$175                     __________
                                                                             $____        ___
    mate Neck __
Ultim           _________________ Daate________
                                              __________
                                                       _$175                     __________
                                                                             $____        ___
    mate Arm & S
Ultim                     ________ Da
                Shoulder __         ate________
                                              __________
                                                       _$175                     __________
                                                                             $____        ___
    mate Abdominal Massag _____ Da
Ultim                     ge        ate________
                                              __________
                                                       _$175                     __________
                                                                             $____        ___
    mate Practica ________
Ultim           al        _______ Daate________
                                              __________
                                                       _$175                     __________
                                                                             $____        ___
Entire Ultimate Series ____         __________
                           __________                   $960
                                              __________$                        __________
                                                                             $____        ___

Clinical Nutrition for Massag Therapists
                 n           ge          s_________
                                                  __________
                                                           _$100                 __________
                                                                             $____        ___
Mass              py
     sage Therap Facial___   __________ ___________
                                                  _________ $160                 __________
                                                                             $____        ___
Tradditional Shiattsu (Parts 1 and 2) ____
                                         __________
                                                  __________
                                                           _$300                 __________
                                                                             $____        ___

    ment       is        d          orkshop
Paym in full i required day of the wo                 Tota enclosed
                                                         al                   __________
                                                                          $____         ___
              ecks payable to: New Je
Please make che                                ge
                                    ersey Massag
   a
Visa          rcard
         Master        Diiscover      Number___          __________
                                               ___________                              ___
                                                                    _______Exp. Date_____

   nature______
Sign                   ___________
              __________                  ___________
                                 ___________        __________

				
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