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IICT Practitioner Directory Listing -- Deluxe

Fill out the form below and click "submit" to purchase your Deluxe IICT Directory Listing Do not put spaces in credit card entry

IICT Deluxe Practitioner Directory Listing Form

* indicates mandatory fields

Title DRMISSMRMRSMS

First Name *

Last Name *

Email *

Practitioner Name

Practice Name

Address of premises to appear in listing

Practitioner Qualifications to appear in listing

Phone Number

Mobile Phone Number

Practice email address

website address

Practice Description (up to 30 words)

The principal healing modality for my listing is -- Please Select --Access Energy TransformationAcupunctureAcupressureAlexander TechniqueAllergy Testing/TreatmentsAnimal TherapiesAqua DetoxAromatherapyArt TherapyAsthma RehabilitationAstrologyAura-SomaAyurvedaBates MethodBeauty TherapyBio FeedbackBody HarmonyBOWENBrain GymBreathworkBush FlowersButeykoChakradanceChinese MedicineChiropracticColonic IrrigationCounsellingColour TherapyCore EnergeticsCraniosacral BalancingCrystal TherapyDance/Movement TherapyDay SpasDemartini MethodDietDorn MethodDoulaDr. James MethodEar CandlingEMF BalancingEmmett TechniqueEFT Emotional Freedom TechniqueENAREnergy HealingExerciseFeldenkraisFeng ShuiFlower Essence TherapyFree to be MeGestalt TherapyHealing TouchHeal Your LifeHellerworkHolographic RepatterningHerbal MedicineHomoeopathyHypnotherapyInner ChildIridologyKinergeticsKinesiologyLaser TherapyLife CoachingLymphatic DrainageMagnetic Field TherapyMassageMassage ChineseMassage ClinicalMassage Connective TissueMassage CorporateMassage Deep TissueMassage Indian HeadMassage Infant/BabyMassage Hot StoneMassage KahunaMassage Lomi LomiMassage Mobile ServicesMassage pregnancyMassage Qi Gong (Chi Kung)Massage remedialMassage Seated (Chair)Massage SportsMassage SwedishMassage ThaiMeditation Men's Health MetamorthisesMusic TherapyMyofascial ReleaseMyotherapyNatural FertilityNaturopathyNLPNutritional TherapiesOsho ModalitiesOsteopathyPersonal TrainingPilatesPodiatryPolarity TherapyPrimal TherapyPranic HealingPsychotherapyPSYCK-KQi Gong/Chi-KungQuantum TouchQuit SmokingRaynor TechniqueRebirthingReconnective HealingReflexologyRekindled Ancient WisdomReikiRelaxation TherapyRemedial TherapiesRolfingRosen MethodRotai Pain ReliefScenar TherapySHIATSUSleep TherapySound Therapy/HealingSpinal TouchSpiritual HealingSports Injury TherapyTai ChiTouch for HealthTENS Machine TherapyTibetan PulsingTime Line TherapyTherapeutic TouchThe JourneyTheta HealingTFT Thought Field TherapyThe Trager ApproachTranspersonal Counselling/TherapyTranspersonal Art TherapyTrigger Point TherapyWatsuWeight LossWhole-Hearted Healing Women's Health Wu TaoYogaYogalatesZen

Additional modality headings required for my listing (add $10 to total for each)

Name on Card *

Card Number Please do NOT add spaces between numbers*

Card Expiry * Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Card Type * Visa Master Card American Express

Amount *

AUTO-RENEW The Hassle Free Way to Save YOU Time at Renewals! DIRECT DEBIT REQUEST- Please retain my credit card details and automatically debit my credit card on June 30th each year to automatically renew my listing. ( Tick for YES)

* indicates mandatory fields