Registration Form

Class Attending____________________________________

Class Date________________________________________

First Name________________________________________

Last Name________________________________________

Address___________________________________________
_________________________________________________

CitY______________________________________________

State_______________________ Zip___________________

Phone ___________________________________________

Email Address_____________________________________

L.M.T. License Number______________________________

Mail Completed Registration Form and  Payment to:

ISB/College of Natural Health
1932 SW 3rd St. Suite 4
Ankeny, IA 50021

*$50 non refundable cancellation fee.

*When registration is received confirmation along with further information regarding the class you have registered for will be emailed to you.