Bank Transfer Instructions

Name *

First

Last

I am a......... *

Chiropractor
Student of Chiropractic
Builder of the Field Chiropractor

Student of Chiropractic registration for Posterior & Anterior Geometry Theory online and inPerson weekend. Please send via email or WhatsApp a photo of your current school ID to verify your student status to receive the seminar discounted price.

Email *

WhatsApp Phone Number *

For each seminar we create a WhatsApp group comprised of the attendees.

Choose the seminar you wish to attend *

Quantity *

Please use the special requests or questions box to provide names emails and WhatsApp and I am a.... answers. If you are seeking to pay for someone else as a gift as well as for yourself please send a WhatsApp or email the contact info for the other person(s)

Wise Bank transfer currency choices *

Euro
Great Britain Pound
US Dollar

Please choose the currency you wish to use for your Wise bank transfer link

Office Address or other for your receipt *

Please provide address information that you wish to appear on your receipt

City *

State / Province / Region *

Postal Code *

Country *

Special requests or questions

Confirmation *

I acknowledge that I have read and agree to abide by the the Terms and Conditions

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Bank Transfer Instructions

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