The Bowen Institute: Registration form

The Bowen Therapy Academy of Australia

Canadian Registration Form

Contact:	Derek Murphy B.Sc., N.D. Tel: 905.813.6161 Fax: 905.813.7997 registration@boweninstitute.ca
Deadline:	Class sizes are limited. Contact our office for registration deadlines.
Deposit:	$150.00 per module (non-refundable)
Course fees:	Bowen Canada member fee per module: $385.00 Non-member fee: $450.00 *Bowenworks* registration/membership - $103.48 - includes: 1-year membership Module fees discount *Bowen Hands* 1-year subscription
Payment:	Please make course fee check payable to: *The Bowen Institute* Make Bowenwork registration $103.48 check payable to: *Bowen Canada Registry*
Location:	Please contact our office for course locations
Times:	9:00 AM - 5:00 PM - unless specified

Name:

Permanent Home Address:

Work Address:

Home Tel:

Work Tel:

Fax:

Other:

Email:

Occupation:

Practitioner Lic./Student:

Please print this form out, fill in your information, and submit with your payment.