japan project

Submission Form

Name

Identity Card Nr.

/ / Date of Birth

Nationality

Address

Telephone Nr.

E-mail Address

Profession

Education and Training

*If you already have background of studies in the medical/ therapeutic area (western or oriental), please attach a copy of your certificate(s)/diploma(s) and short personal history (zip, rar, pdf, max 2Mb).

Please mark the seminar(s)/course(s) you wish to attend:

General Shiatsu | Advanced Shiatsu | Zen Shiatsu
Seitai | Foot Reflexology | Ryodoraku Acupuncture

Please select the mode of payment of the security deposit: