Daniele Henkel Seminar Registration Form
 
Pre-Register to receive free admission to the show. Please note this is a "trade only" seminar and only those who qualify will receive admittance.
 

Contact Name*

Company*

Street Address*

Province/State*

Postal/Zip*

Telephone*

Email Address*

Please describe your company's products and/or services.*

What is your position with this company?*

What methods do you currently use for treating cellulite?*

Please choose the Endermologie seminar you wish to attend:*
Friday, October 19 ~ 5pm
Sunday, October 21 ~ 1pm

Thank you for taking the time to fill out this Registration Form. A complimentary admission ticket will be sent to you by mail. Please enter any comments or suggestions here.

 
* Indicates field is required.