Enrolment

Shiatsu College Aotearoa Enrolment Form

To enrol, print out this form, fill in your details and post to:

Shiatsu College Aotearoa * P.O.Box 15264 * Tauranga *New Zealand
Tel 0800 SHIATSU or 0274 790068. Or enrol through email

Date : ________________

First Name:_________________________________________________________________

Family Name:_______________________________________________________________

Address:___________________________________________________________________

___________________________________________________________________

Phone: ____________________________________________________________________

Fax:_______________________________________________________________________

E-mail address:______________________________________________________________

Course Applying For:

1. Introductory Shiatsu Weekend___

2. Diploma of Shiatsu ___

3. Short course ___

   ___Shiatsu during pregancy
   ___Facial Diagnosis
   ___Introduction to Oriental Medicine and Philosophy
   ___Nutrition
   ___Nutritional Cooking and Oriental Facial Diagnosis
   ___Acupressure point location and function

Other comments: ____________________________________________________________

__________________________________________________________________________