Clone of REGENERATIVE DRY NEEDLING LEVEL 1

REGENERATIVE DRY NEEDLING LEVEL 1 & 2 BUNDLE

All sales are final for this bundle. Each course must be taken within 1 year of original purchase date. Level 1 must be taken prior to Level 2.
NAME*

First NameMiddle NameLast Name
PROFESSIONAL CREDENTIAL(s)
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
EMAIL (personal email recommended)*
PHONE NUMBER

Area CodePhone Number
EMPLOYER
REFERRAL SOURCE*

IAR FACULTY / STUDENTIAR WEBSITEAPTA / NATAE-NEWSLETTERSOCIAL MEDIAOther
IF REFERRED BY IAR FACULTY / STUDENT, PLEASE IDENTIFY THIS INDIVIDUAL
PLEASE INDICATE DATE AND LOCATION OF YOUR PREFERRED LEVEL 1 COURSE*
PLEASE INDICATE DATE AND LOCATION OF YOUR PREFERRED LEVEL 2 COURSE*
T-SHIRT SIZE
Additional Comments
PLEASE COMPLETE PAYMENT TO CONFIRM PARTICIPATION IN THE COURSE.
PLEASE "SUBMIT" TO FINALIZE APPLICATION FOR REVIEW
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DN BUNDLE$1,750.00

Total $0.00

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REGENERATIVE DRY NEEDLING LEVEL 1 & 2 BUNDLE