Registration

Thank you for your interest in the School of Thai Massage. Please use this form to get in touch with us regarding our courses. We shall contact you with the confirmation process or the information you require within one working day. If you would like to keep it simple write in to [email protected] or call us in India at +91-9620378868 / +91-9449837130 or Whatsapp us at  +1-(913) 215-1277 (United States).  We look forward to sharing the art of Thai Massage with you.

{source}
<!– Begin MailChimp Signup Form –>
<link href=”//cdn-images.mailchimp.com/embedcode/classic-10_7.css” rel=”stylesheet” type=”text/css”>
<style type=”text/css”>
#mc_embed_signup{background:#fff; clear:left; font:14px Helvetica,Arial,sans-serif; }
/* Add your own MailChimp form style overrides in your site stylesheet or in this style block.
We recommend moving this block and the preceding CSS link to the HEAD of your HTML file. */
</style>
<div id=”mc_embed_signup”>
<form action=”//tyms.us5.list-manage.com/subscribe/post?u=0ef05edb6b40e012b7283a29b&amp;id=fa63b40ba5″ method=”post” id=”mc-embedded-subscribe-form” name=”mc-embedded-subscribe-form” class=”validate” target=”_blank” novalidate>
<div id=”mc_embed_signup_scroll”>
<h2>Registration Form</h2>
<div class=”indicates-required”><span class=”asterisk”>*</span> indicates required</div>
<div class=”mc-field-group”>
<label for=”mce-FNAME”>Name <span class=”asterisk”>*</span>
</label>
<input type=”text” value=”” name=”FNAME” class=”required” id=”mce-FNAME”>
</div>
<div class=”mc-field-group”>
<label for=”mce-EMAIL”>Email Address <span class=”asterisk”>*</span>
</label>
<input type=”email” value=”” name=”EMAIL” class=”required email” id=”mce-EMAIL”>
</div>
<div class=”mc-field-group input-group”>
<strong>Preferred Venues </strong>
<ul><li><input type=”radio” value=”Nevada City, California” name=”VENUE” id=”mce-VENUE-0″><label for=”mce-VENUE-0″>Nevada City, California</label></li>
<li><input type=”radio” value=”Bangalore, India” name=”VENUE” id=”mce-VENUE-1″><label for=”mce-VENUE-1″>Bangalore, India</label></li>
<li><input type=”radio” value=”Mysore, India” name=”VENUE” id=”mce-VENUE-2″><label for=”mce-VENUE-2″>Mysore, India</label></li>
</ul>
</div>
<div class=”mc-field-group”>
<label for=”mce-MMERGE3″>Course interested </label>
<select name=”MMERGE3″ class=”” id=”mce-MMERGE3″>
<option value=””></option>
<option value=”Basic Level”>Basic Level</option>
<option value=”Intermediate Level”>Intermediate Level</option>
<option value=”Anatomy of Thai Massage”>Anatomy of Thai Massage</option>
<option value=”SwaTanTra : Pain Therapy”>SwaTanTra : Pain Therapy</option>
<option value=”Foot Reflexology”>Foot Reflexology</option>
<option value=”Toksen”>Toksen</option>

</select>
</div>
<div class=”mc-field-group size1of2″>
<label for=”mce-MMERGE5-month”>Preferred Date of Participation </label>
<div class=”datefield”>
<span class=”subfield monthfield”><input class=”datepart ” type=”text” pattern=”[0-9]*” value=”” placeholder=”MM” size=”2″ maxlength=”2″ name=”MMERGE5[month]” id=”mce-MMERGE5-month”></span> /
<span class=”subfield dayfield”><input class=”datepart ” type=”text” pattern=”[0-9]*” value=”” placeholder=”DD” size=”2″ maxlength=”2″ name=”MMERGE5[day]” id=”mce-MMERGE5-day”></span> /
<span class=”subfield yearfield”><input class=”datepart ” type=”text” pattern=”[0-9]*” value=”” placeholder=”YYYY” size=”4″ maxlength=”4″ name=”MMERGE5[year]” id=”mce-MMERGE5-year”></span>
<span class=”small-meta nowrap”>( mm / dd / yyyy )</span>
</div>
</div>
<div class=”mc-field-group”>
<label for=”mce-MMERGE6″>I need accommodation <span class=”asterisk”>*</span>
</label>
<select name=”MMERGE6″ class=”required” id=”mce-MMERGE6″>
<option value=””></option>
<option value=”Yes”>Yes</option>
<option value=”No”>No</option>
<option value=”Not sure yet”>Not sure yet</option>

</select>
</div>
<div id=”mce-responses” class=”clear”>
<div class=”response” id=”mce-error-response” style=”display:none”></div>
<div class=”response” id=”mce-success-response” style=”display:none”></div>
</div> <!– real people should not fill this in and expect good things – do not remove this or risk form bot signups–>
<div style=”position: absolute; left: -5000px;” aria-hidden=”true”><input type=”text” name=”b_0ef05edb6b40e012b7283a29b_fa63b40ba5″ tabindex=”-1″ value=””></div>
<div class=”clear”><input type=”submit” value=”Subscribe” name=”subscribe” id=”mc-embedded-subscribe” class=”button”></div>
</div>
</form>
</div>

<!–End mc_embed_signup–>
{/source}