Intro to Hendrickson Method®
(Low back & Neck)
Los Angeles June 2, 2018 10am-5pm

Hello! I'm thrilled to offer this intro class to the Hendrickson Method® of orthopedic massage and manual therapy. This remarkable therapy has enabled hundreds of therapists to be more effective, comfortable and confident in providing life-changing treatment for orthopedic conditions. To enroll, please complete this application and make payment of the $147 course fee. We look forward to receiving your application, and getting back to you with confirmation of your acceptance into enrollment!
Warm regards,
Craig Harris, Hendrickson Method® Instructor

** If you have any questions or problems completing this application,
please contact us at: training@HarrisManualTherapy.com **

APPLICATION

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* 1. FIRST Name

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* 2. LAST Name

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* 3. EMAIL

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* 4. CELL phone

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* 5. WORK phone

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* 6. HOME phone

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* 7. ADDRESS

Address

City

State

ZIP

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* 8. OCCUPATION

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* 9. COMPANY NAME

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* 10. WEBSITE

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* 11. List your EDUCATIONAL background in health areas, including anatomy and manual therapy. (Feel free to drag the bottom right corner to size this field)

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* 12. List your professional EXPERIENCE in the health professions, including manual therapy, movement, or related work. (Feel free to drag the bottom right corner to size this field)

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* 13. I am applying for (choose all that apply):

June 2, 2018 10am-5pm Los Angeles $147 Intro to Hendrickson Method® (Low back & Neck)

Congratulations, you're done... almost!
Please make payment of your $147 course fee.
Your payment now will begin the processing of your application and reserve your spot in the training, subject to approval of your application. (If there is not a spot for you in this training, your $147 payment will be refunded.)

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* 14. I am making payment by:

Credit card. I provide my credit card info below.

Credit card. I prefer to call (818) 454-1136 within the next business day, during office hours M-F 10a-4p, to provide my credit card info.

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CREDIT CARD INFO
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We accept Visa, MasterCard, and AmericanExpress.

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* 15. NAME (as displayed on credit card)

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* 16. CARD NUMBER

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* 17. MMYY

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* 18. CVV

We are so pleased you're applying to this training! Please contact us if you have any other questions.
HARRIS MANUAL THERAPY (818) 454-1136 M-F 10a-4p school@HarrisManualTherapy.com