Body Contouring Training

Workshop Registration Form
Name *

First Name Middle Initial Last Name
Birth Date *

Month Day Year
Gender *

Male Female Decline to Answer
Are you Hispanic or Latino? *

No Yes Decline to Answer
Race: *

American Indian/Alaskan Native Asian Black Native Hawaiian/Other Pacific Islander White Decline to Answer
Of which country are you a citizen? *
Phone *

Area Code Phone Number
E-mail Address *
Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

$1299 Tuition Fee

$100.00 Non-refundable deposit is Required to hold seat. Payment Due in Full 3 days before class
Payment Method: *

Credit Card In-person at school

My Products

Deposit $ 100.00

The initial $100.00 deposit will reserve your seat for training, the remainder $1,199.00 will need to be paid in full 3 days before class

Minus Deposit $ 1,199.00

Full Tuition $ 1,299.00

Total $ 0.00

Workshop Registration Form