ZEN SHIATSU SOCIETY - MEMBERSHIP ACTIVATION - printer-friendly form back
| YOUR NAME | |
| MOBILE/PHONES | |
| EARTH-ADDRESS incl POST-CODE | |
Circle one: |
Which MEMBERSHIP REGISTER is appropriate for you? |
| MZSS * | associate and supporter of Zen Shiatsu including practitioners of other therapies: MZSS |
| JZSS * | Junior Practitioner in further training and certified by one Teacher to be competent in Practical Shiatsu |
| IZSS * | Intermediate Practitioner in further training and acknowledged by two Teachers to have attained Intermediate Level in Zen Shiatsu |
| PZSS * | Practitioner Member licenced by Three teachers to practice Zen Shiatsu |
| TZSS | Teacher Member acknowledged by the membership as a Teacher of Zen Shiatsu |
| SCHOOL | School Member |
* name/s of teacher/s |
|
| HELP | The Charter of our Zen Shiatsu Society is to help our Members. Think of what skills, knowledge and resources you share and write it below. If a member is in need we may refer them to you and if you need help we will put you in touch with someone. |
| Other Therapies | |
| SUBSCRIPTION DONATIONS | Our Society's entire income is from voluntary Donations. Please give what you can afford. |
By cheque |
Please make your cheque payable to Zen Shiatsu Society and send it with this form to Zen Shiatsu Society, 1st Floor, 68 Great Eastern Street, London EC2A 3JT |
By credit/debit |
AMOUNT £______ CARD NUMBER:
______________________3-digit security code (on back of card)______ START DATE________EXPIRY DATE_________switch/solo ISSUE no:_____ |
THANK YOU! |
When you have completed this form please print
it out and send in to Zen Shiatsu Society,
1st Floor,
68 Great Eastern Street,
London EC2A 3JT We will then send you your Membership Certificate and Insurance Proposal for you to send on direct to the Insurers |