Teresa's Therapeutic Massage Spa and School

For more information, please give us a call at the number
listed to your left, or fill out our online form below.

Name
Phone
EMail
Occupation
Social Security Number
Drivers License
Date Of Birth

Teresa's Therapeutic Massage Spa and School
4027 South Webster Street
Kokomo, IN 46902

E-mail ttmassagecenter@sbcglobal.net

Phone: 765.455.0570

1-877-455-0570 (toll free)
Fax: 765.455.3970

Click below for Map

Address
City	State Zip

Emergency Contact Relationship Phone

Form Of Payment

Check one: 26hr Intro to Massage Option 1 Option 11 Option 111 Workshop

* Please send payment to :
Teresa's School of Therapeutic Massage
4027 South Webster Street
Kokomo, IN 46901
Or call 765.455.0570 to pay by credit card.

References
Name
Relationship
Address
Phone

Name
Relationship
Address
Phone

Please Explain Your Interest In Massage Therapy

Redress

Student questions, concerns or grievances in any area should be directed to the Director of Education.

I do agree to the above stipulations of payment for Teresa's School of Therapeutic Massage. I am
fully responsible for complete payment of any and all cost acquired during the course of this class to Teresa's School of
Therapeutic Massage.