Application Form

Required fields are marked with an asterisk (*)
I WISH TO BOOK (Please fill in Course’s date) *
First Name * Surname *
Female Male Date of Birth
First Language Place of Birth
Postal Address

Telephone - Home

Telephone - Work

Telephone - Mobile

Email *

Occupation

How did you find out about Byron Thai Massage School?
(Please write how you heard about it, which advertising, magazine, print out, flyer, friend, web site/ internet search, others)

Have you ever studied Thai Massage before?
Yes No

 If yes, where? How long?

Have you ever studied any other Massage technique?
Yes No


 If yes, which ones? How long?
Do you practice Massage?
Full-time Part Time As a Hobby To Friends/ partner No
Have you ever practiced any Yoga, Pilates or any form of martial arts or dance? Yes No

Yes No

What?

Which Style?

How Often?

Do you consider yourself physically fit? Yes No

How is your flexibility?

How is your strength?

How do you consider your body awareness?

Are you interested in the 1hr yoga class every morning? Yes No
Would you rather do your own practice start 1 hr later? Yes No

Please write down any health problem, injury, old surgery, joint/mobility problem:

Do you Smoke? Yes No
What is your motivation towards this course? What would you like to do with what you will learn, once you have finished?
I have read and agree to the course Fee And Refund policy of Byron Thai Massage School      *   Yes