Class Registration Form

INFUSION CENTER MASSAGE 101

Create a new account

Do you already have a user account? Link here to login to your account
User Name(Required)
Certificate Name(Required)
If you would like to include your credentials on your class certificate please include those after your last name in EXACTLY the way you would like them printed on your certificate i.e. include commas where you want them, e.g. Sally Smith, MLD or Sally Smith MLD
Password
Which professional license and certifications do you hold? Mark all that apply. *(Required)

Have you completed a S4OM/S4OE oncology massage or oncology esthetics approved Foundation training program?(Required)
Have you completed any other oncology massage or oncology esthetics training program?(Required)
Are you currently or have you ever been a professional member of S4OM or S4OE?(Required)

Terms and Policy(Required)