Holistic Promotions - Registration Form for Holistic Therapists, Practitioners and Healers

HOLISTIC THERAPISTS / PRACTITIONERS / HEALERS
REGISTRATION FORM

Please fill in your details and submit the form below
FOR A LISTING IN OUR ONLINE THERAPISTS DIRECTORY

If you haven't already done so, please first click here to read our Term & Conditions.

We also recommend that you click here for some advice on what you should or shouldn't include on the form, to get the most out of your listing.

WHEN FILLING IN THE FORM...
Please enter your details using both Upper and Lower case text, as appropriate, for normal readability. (ie. Don't use all Capital Letters, or all lower case letters.)

(NOTE: If you already have a listing in the Therapists Directory, and need to update it,
please don't use this form. Instead go to the Therapists Update Form)

Practice / Business Name
(or the name you normally work under as a therapist)

Who the entry is for?
(Select one only)

Individual Practitioner
Clinic or Group Practice*

Your First name
Your Last Name
This will be shown as the Practitioner Name in your entry.

*(If you're submitting details for a Clinic/Group Practice, please give a Contact name here which can be included in your entry.)

Landline Phone No.
If you don't have a landline number, or if you prefer not to show it on the website, please just enter '000' here.

Mobile Phone No.

Email Address
The one you normally use for business enquiries

Website Address http://

In which town(s) do you mainly practise?

Please select the County/area
you mainly work from
(1 only)

Cumbria	Cheshire	Wirral
North Wales	Lancashire	Merseyside
	Gtr Manchester

On which Therapy pages would you like your entry to be displayed on?
You can select up to five
Help Tip: When you've finished selecting your therapies, remember to click the mouse away from the dropdown list first, before you scroll down the page to the next question.

1			4
2			5
3

Do you visit clients at home?

Yes No

*Are you insured?

Yes No

*Qualifications / Memberships
(These must be included in all practitioner entries)

Abbreviated	Full Version





Any others?

*Please note:
We don't require proof of qualifications, insurance etc., however, we do state on the website that any practitioner listed is happy to show evidence of these to any client who asks.

If you would like your practice address shown in your entry, or the address of a clinic or therapy centre you work from, please enter the name and full address of the practice (inc.postcode)

Name of Practice

Address of Practice (inc. postcode)

Address:

Town:
County:
Postcode:

About Yourself
Briefly describe anything about yourself or your practice that you would like to tell potential clients. e.g, the way you approach your work, experience, specific health problems you specialise in, any additional or unusual therapies you offer, etc.
No more than 150 words please!
(Over-long profiles will be edited at our discretion)

Nearly finished!

All the information you have given above will be used to prepare your entry for inclusion in the Therapists Directory on our website, which is available for public viewing worldwide via the internet.
Please tick this box to say you have read and understood our Terms & Conditions

Finally, please complete the details below - FOR OUR RECORDS ONLY
(information in this section will not be displayed in the directory)

Title

Other

Please give your full address
(and your Landline Phone Number - if you have one and haven't included it above)

This information will not be displayed on the website unless you have also given it above for public use. We may use it to get in touch with you about your listing if we're unable to contact you by email. We never pass on or sell your private details to any third parties for marketing purposes.

Address:

Town:

County:

Postcode:

Phone:

HOW TO PAY FOR YOUR LISTING:
The annual fee for advertising in our Therapists Directory is £15. We only ask you to pay for one year at a time.

You can choose to pay NOW securely online by Credit/Debit Card, or with your PayPal account, or if you prefer, you can send us a cheque in the post. (Please note: it isn't necessary to have a PayPal account to use the online payment option)

When you have checked the details you've entered and are happy with them, please click the 'Submit' button below. You will then be taken to a page with payment instructions where you can choose how to pay.

We'll prepare your entry for you and, provided we've received your payment in time, your details should be on the website within 7 days. We'll email you with a receipt and also confirm when your listing has gone on display.

Note: If you don't appear to receive any Emails from us... please also check your Bulk Mail or 'Spam' folder as well as your usual Inbox.

Please tell us - How did you find out about this site?

Finally, click here to send us your details.
Thank you for supporting The North West Directory of Natural Healing
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