Canberra Mulligan Concept Upper Quadrant: Course Registration

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Saturday 15th February 2020, registration from 8:30 for 9:00 to 5:00
Sunday 16th February 2020, 9:00 to 4:00
Event Address: Belconnen Physiotherapy Clinic, 1/20 Purdue Street Belconnen, Canberra, ACT
Contact us at grant.mackay@graduate.curtin.edu.au

Email *

Name (as you would like it on your course certificate) *

I am happy to receive email regarding the Mulligan Concept, including upcoming courses

Yes

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Phone *

Qualification *

Physiotherapist

Chiropractor

Osteopath

Medical Doctor

Dietary requirements *

No special requirements

Vegetarian

Gluten-free

Other:

How would you like to receive your course notes? *

PDF electronic copy only (no paper manual supplied at the course)

Printed course manual only (supplied at the course)

Both PDF electronic copy and printed course manual

Which Mulligan Courses have you previously undertaken?

Upper Quadrant (Part A)

Lower Quadrant (Part B)

Advanced Course (Part C)

I have not attended any Mulligan Concept courses previously

Can you please tell us how you heard about the course?

Facebook

bmulligan.com

Previous course attendee

Referral from colleague or workplace

Twitter

Other:

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Upon completion of this form, payment details will be provided by email. Your place on the course will only be confirmed upon receipt of payment. *

Please send me bank details for a direct deposit

Please send me an invoice through Square for card payments (attracts 2.2% surcharge)

If you need address and/or company name details for your receipt, please provide these details below.

Any questions regarding the course you would like answered before you attend?

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