ITTA On-Line Registration Form

Eleventh Annual ThaiLand Externship

Please Fill form out completely. Thank you.

Name:

E-Mail:

Company:

Street Address:

City, State, Zip:

 ,

Phone:

 We must have good phone number to process your registration.

Tuition Payment or Deposit:
 Please indicate your interest in Alternative excursions/ sidetrips instead of Massage training: A) Yunan China B) Vietnam or C)Thailand/ Koh Samuii Beach  

Will you need assistance in booking your connecting travel or flights to our common departure point?
Payment Type (No personal Checks Please)

MasterCard Visa Amex

Cashiers Chek /Money Order (US Funds)

Credit Card number In interest of security, to use a credit card please call ITTA at (231) 861-0481, leave a phone where you can be reached, and we will take your order directly. This avoids all possibility of fraud with your Card!


CopyRight© 2002

This page last updated 04/13/2002