BodyTalk
Access Seminar Registration
AcccessBodyTalk Seminar
REGISTRATION FORM

Module: Access __City: Winnipeg__ Date: Saturday February 27, 2010

Please Check One: ____ New ____ Monitor ( IBA membership req'd)



Student Information - Please print neatly

Name (as for certificate) ___________________________________________________

Address ________________________________________________________________

City _______________________ State/Country _____________ PostalCode _________

Phone ___________________________ Alternate phone _________________________

Email __________________________________________________________________


Payment Information:

Method of Payment: O Check O Cash O Paypal O email transfer

Make checks payable to: Nigel Jeffers.

Paypal and email transfer can be sent to: nigeljeffers@shaw.ca

Mail to:

The Muscle Therapy & Integrated Bodywork Clinic
1547 Grant Avenue
Winnipeg. MB R3N 0M4

Nigel Jeffer's certifications include: CBI, Access Trainer, BSc. RMT, CBP, BAT, Parama BP

Nigel Jeffers Muscle Therapy and Integrated Bodywork Clinic 1547 Grant Avenue Winnipeg, Manitoba 204.779.9119