Therapy directory Registration Form

Please note that SECTION1 below is entirely free of charge but only your organization/business name will be listed in the directory. If you wish to have your contact details and various additional information listed then please fill out the appropriate sections of this page and you will be taken to PayPal out credit/debit card payment gateway. Alternatively, you can simply fill this form in, print it out and post it with a cheque made out to Therapy Directory to Therapy Directory PO Box 7419 Annan DG12 5WX.

SECTION1 - FREE Registration
Business Name
Last name		First name
Address		Position/Title
Town		Region County	Region County
Post Code		Country	United Kingdom
What best describes your business	Please Choose .... Green café / restaurantOrganic ProduceOrganic FoodHealth FoodNatural ProductsNatural HealthNatural FoodsHealthy EatingWhole FoodHealth ShopMail OrderOther

SECTION2 - Contact information £20 Annual Registration Fee
		Website
Phone		Mobile
FAX		Email
Opening times
Dtails of Business
Specialities
Other Information

Additional Headings - £2 per additional heading Annual Registration Fee
Please choose .... Therapy1 - No selectionGreen café / restaurantOrganic ProduceOrganic FoodHealth FoodNatural ProductsNatural HealthNatural FoodsHealthy EatingWhole FoodHealth ShopMail OrderOther Therapy2 - No selectionGreen café / restaurantOrganic ProduceOrganic FoodHealth FoodNatural ProductsNatural HealthNatural FoodsHealthy EatingWhole FoodHealth ShopMail OrderOther Therapy3 - No selectionGreen café / restaurantOrganic ProduceOrganic FoodHealth FoodNatural ProductsNatural HealthNatural FoodsHealthy EatingWhole FoodHealth ShopMail OrderOther Therapy4 - No selectionGreen café / restaurantOrganic ProduceOrganic FoodHealth FoodNatural ProductsNatural HealthNatural FoodsHealthy EatingWhole FoodHealth ShopMail OrderOther Therapy5 - No selectionGreen café / restaurantOrganic ProduceOrganic FoodHealth FoodNatural ProductsNatural HealthNatural FoodsHealthy EatingWhole FoodHealth ShopMail OrderOther	If as an organization you operate a cafe and sell healthfood and natural products you can register all your details under additional headings for an additional £2 per heading. To choose up to five additional therapies, use the lists opposite.
Top listing for your region £100 Annual Registration Fee
Please register first