Authentic Ayurveda Professional Development Series* Registration Form

Nov. 30th - Dec. 4th, 2009.
Please Call 417-863-PMTC with any questions.

First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone 1:
Phone 2:
E-Mail:

Cost of Registration:	$1,000.00 New Registrant (iSPA members will receive a free ayurvedic treatment starter kit) $650.00 PMTC Graduates and Current PMTC Students $25 Ayurvedic Treatments for Health & Wellbeing 2-Hour Seminar December 1, 2009 7:00pm-9:00pm
Payment Method:	Credit Card Check

Credit Card Information:
Name on Card:
Number:
CIV Number:
Expiration Date:

I authorize PMTC to charge my credit card provided.

Professional Massage Training Center's Ayurvedic Therapy Professional Development Series is designed to teach assessment and treatment of medical conditions. By checking the box below, you verify that you meet the legal requirements for your state and/or local municipality to practice massage therapy or bodywork as a healthcare occupation or are a currently enrolled student in massage therapy training.

I meet the legal requirements for my state and/or local municipality to practice massage therapy or bodywork as a healthcare occupation or am a currently enrolled student in massage therapy training.

*Professional Development Series are not a part of PMTC's accredited curriculum.