Application Form

Required fields are marked with an asterisk (*)
I WISH TO BOOK (Please fill in Course’s date) *
First Name * Surname * Upload your photo
(max 500k)
Female Male

Date of Birth

Age

First Language Place of Birth
Postal Address

Main closest town or city

Telephone - Home

Telephone - Work

Telephone - Mobile

Email *

Occupation

How did you find out about Byron Thai Massage School?
Please be specific, write how you heard about it, which advertising, which exact magazine (Wellbeing, Living Now, Nature & Health, Australian Yoga Life, Body & Soul), 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, where and how many hours was each course?
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 and 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

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