REGISTRATION FORM

 

    Sign me up for: ______________________________________Date: ______________

 

        For upper body lymph, please check number of hours ______6 ______8

 

    Name: ________________________________________________________________

 

    Address: ______________________________________________________________

 

    City: _______________________________________________Zip: _______________

 

    Phone(s): _____________________________________________________________

 

    Email: ________________________________________________________________

 

    You must send a $50.00 to reserve a spot in the class; balance due the day of class.

 

    A CONFIRMATION, WHAT TO BRING, AND A MAP WILL BE SENT UPON 

    RECEIPT.

 

    Thank you!     I look forward to working with you.

 

    Don M. Williams LMT, MTI, CEP

 

    Mail to:   Don M. Williams

                  7524 Mosier View Court, Suite 104

                  Fort Worth, Texas   76118

Web site designed & hosted at Homestead™