Home > Contact > Registration form

You can register for the Iokai Shiatsu basic year by completing the form on our website. Your registration will be final after we have received your registration form, the preliminary interview has taken place and the tuition fee has been paid.

Personal data

Initials

First name

Prefix

Surname

Date of birth

Highest level of prior education

Current profession

Address

Street

Number

Postal code

City

Contact data

Email address

Telephone number

Preferred day lesson

 Monday (Amsterdam) Tuesday (Delft) Thursday (Amsterdam)

Payment

 all at once before the start of the year in four installments. Extra costs: € 50,-

Conditions

 I accept the general terms and conditions

 I give consent to Iokai Shiatsu to hold my personal data in accordance with our privacy policy