Registration

Date: Saturday, _______

Deadline for enroling is Saturday, ___________ !
That's because Ilkay has to reserve a flight and plan the journey from London!

Herewith I am enroling myself for the Cupping workshop with Ilkay Zihni Chirali in Roedekro/Denmark.

The course-fee (£ 65.00 / € 108.00 / DKK 798.00) has been transfered.
(will not be repayed, except the workshop is refused).

Center of Chinese Medicine ApS:
Denmark: Jyske Bank, DK - 6400 Sønderborg, Account No. 7257 / 107902-8
Germany: Jyske Bank Hamburg, BLZ 200 205 00 – SWIFT JYBADEHH, Account No. 0965292901.
.

Please use the possibility to send this page via e-mail (--> "File", --> "Send",--> "Page with email...", then fill out the form below inside your e-mail programm (you have to dobble-click on the fields) and send it to mail@center-of-chinese-medicine.com )
You can also print and fax this side to 0045-74 69 41 93

Date -- TT.MM.JJ

*Name*
*Birthdate*
*Adress*
*Adress*
*ZIP-Code*
*City*
*Country*
*Phone (job)*
*Phone (private)*
*Fax*
*E-Mail*
URL

Center of Chinese Medicine Aps
Loekkegaardsvej 62, DK – 6230 Roedekro
Phone: 0045 – 74661638 Fax: 0045 – 74694193
www.center-of-chinese-medicine.com

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last update 12-03-2008