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I would like to register for the following Master Instructor class:                              

 

I would like to register as a:            

 

Name:                   

Name as you would like it to appear on your certificate (if different from above):

                              

Please check this box if you would like to receive 16 CE hours (continuing education credits) from the National Massage Board (NCBTMB) for this class:

(note: massage therapists, physical therapists and other practitioners need to take classes and receive CE hours on an on-going basis.  If you don't know what a CE hour is, you probably don't need to check this box.)

 

Mailing Address:

Street Address or PO Box: 

Town:                    

State:                    

Postal Code:        

Country:                if another country, type over this entry

Telephone number where we can reach you if we have any questions: 

Email address (for electronic confirmation of your registration): 

Note: Master Instructors who are repeating the class don't need to fill in this section. Please skip to the bottom of this form by clicking here, to provide payment information.

I have completed the following levels to date:    Basic        Intermediate        Advanced

I have taken these classes with (if more than one Master-Instructor, please list all):

If you have not yet completed the pre-requisite Basic, Intermediate, and Advanced level classes, please give dates and name of Master-Instructor you are scheduled to take them with:

Basic: 

Intermediate: 

Advanced: 

STUDENTS

The early bird fee is $635 if you register more than 30 days in advance of the class. The class fee increases to $685 if you register within 30 days.  A deposit of  $210 is required to reserve your space in any class.  This deposit will be returned in full (or applied to a future class if you prefer) if you cancel more than 30 days in advance.  Your deposit is non-refundable if cancellation occurs less than 30 days in advance.  Your final payment is fully refundable if you do not attend the class.

Note: several classes now include lunch, and an associated fee. See the class location details for specifics.

You can pay your deposit by credit card or PayPal:

(note: we cannot accept checks directly - but you can pay by check via PayPal)

For students who wish to use a credit card (Visa or MasterCard), please use this on-line form (fill in credit card information below) or call us at 845-657-7220 (U.S.).

 

For students who wish to use PayPal, please use this on-line form and we will email you with the instructions to use for making a payment, or call us at 845-657-7220 (U.S.). Or you can send us an email, by clicking HERE. When the fund transfer is received you will be registered.  You will need to go to their website at www.paypal.com to make the payment.

 

Final payments can be made by credit card or cash or money order brought to the class. Credit cards will be charged one week before the class date.  If you would like to pay your balance in cash at the class, please put the exact amount in a white envelope with your name on it. This will streamline the check-in process and ensure that all classes can begin on time.We cannot accept balances by check at the class.

I would like to pay my deposit by:  

I would like to pay my balance by:

If you have selected to pay by credit card, please fill out the payment information below for credit cards (or you can call us to register at 845-657-7220). The class will be registered in the order in which the deposits are received.  For registrations received after the class is filled, no charge will be made to your credit card, and your name will be placed on a waiting list.

DEPOSIT

Type of credit card:

Name (as it appears on credit card, only if different from above):

Credit card number:

Expiration Date:   Month:   Year:

Note: Your deposit is fully refundable if you cancel more than 30 days in advance (or we can apply it to a future class if you prefer).  Your deposit is non-refundable if cancellation occurs less than 30 days in advance.  Your final payment is fully refundable if you do not attend the class.

FINAL PAYMENT

If you wish to pay your balance with a different credit card, please fill out the information below (otherwise we will assume balance on the same card):

Type of credit card:

Name (as it appears on credit card, only if different from above):

Credit card number:

Expiration Date:   Month:   Year:

Note: Your final payment is fully refundable if you do not attend the class. 

REPEATING MASTER-INSTRUCTORS

IET Master-Instructors may, space permitting, retake any Master-Instructor class.  The early bird fee to repeat is $95 if you register more than 30 days in advance.  The price increases to $105 if you register (and  space is available) within 30 days of the class.  We will have 4 spaces reserved for repeating Master-Instructors with additional space if fewer than 20 students register. When filling spaces, priority will be given to Master-Instructors who have not reviewed before.

Note: a few classes include lunch, and an associated fee. See the class location details for specifics.

Your payment in full is used to reserve your place in the class and is non-refundable if you cancel less than 30 days in advance. It is fully refunded if you cancel more than 30 days in advance.

For Masters who wish to use PayPal, please use this on-line form and we will email you with the instructions to use for making a payment, or call us at 845-657-7220 (U.S.). Or you can send us an email, by clicking HERE. When the fund transfer is received you will be registered.  You will need to go to their website at www.paypal.com to make the payment.

 

I would like to pay (in full) by:  

If you wish to use a credit card:

Type of credit card:

Name (as it appears on credit card, only if different from above):

Credit card number:

Expiration Date:   Month:   Year:

Students or Repeating Master Instructors, if you have any questions or comments about your registration, feel free to send us more information below.

Comments:

You will receive a written confirmation letter with complete class details from The Center of Being confirming your registration in this class.

 

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Copyright © The Center of Being, Inc                                           
Last modified: May 07, 2012