Asiam Healing Arts
Reflexology Registration Form


Name:_____________________________________________________________________

Address:__________________________________________________________(Street)

________________________(City)______________(State)____________________(Zip)

Telephone:________________(Home)________________(Work)______________(Cell)

Email:_________________________________________________________________

Please enclose your registration form and refundable deposit for $300 in a check/money
order payable to Susan Warren and mail to:

Susan Warren - Asiam Healing Arts
6510 North Camino Libby
Tucson, AZ 85718

Please note: World Reflexology Week is September 19-25 and we will be demonstrating and discussing reflexology in various places around town.  Hopefully you will be able to participate in introducing and educating the public to the benefits of reflexology as a complementary health care practice.  The exact dates and locations will be sent out soon.

Susan Warren
susan@asiamhealingarts.com