Personal data:

Last name:*

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Training

Please indicate the Peter Hess-sound massage seminars that you have taken so far:

Peter Hess®
- Sound massage I

year:

in (location):

Instructor:

Peter Hess®
- Intensive training

year:

in (location):

Instructor:

Final seminar for
KM III + IV

year:

in (location):

Instructor:

Peter Hess®
-Advanced seminar
"Easy, skilful and safe design of
individual sound massage!"

year:

in (location):

Instructor:

Membership list

Please answer the following question with yes or no:

I agree to the publication of my name as part of the membership list on the website of the Internationaler Fachverband Klang-Massage-Therapie e.V. (International Association of sound massage therapy).

 With this application form I hereby file for membership with the Internationaler Fachverband Klang-Massage-Therapie e.V. (International Association of Sound-Massage-Therapy) whose statutes I have read.

The membership fee of Euro 49,- at the moment is to be transferred at the beginning (January) of each year.
The checkboxes marked with * are compulsory and must be filled in.

Bank details:
Internationaler Fachverband Klang-Massage-Therapie e.V.
Kreissparkasse Syke, Deutschland
Account no.: 15 10 04 10 21, Bank code: 291 517 00
IBAN: DE43 2915 1700 1510 0410 21, BIC: BRLADE21SYK

Direct Debit Mandate

I hereby authorize the International Association of Sound-Massage-Therapy, Ortheide 29, D-27305 Bruchhausen-Vilsen, for payments from my / our account by direct debit authorization. At the same time, I instruct my credit institution to encash the direct debits drawn by the payment recipient on my account. This mandate is valid until canceled.

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