Form G - Thai Healing Alliance International

Associate Member Application
Associate Member - Application directions
General Information
There are no requirements for membership on the Associate level, however most Associate Members have direct
connections to massage & bodywork, yoga, energy-based healing traditions, wholesale and retail of supplies and
accessories, tourism, spa services, travel/transportation, education, and publishing.
You must send your completed application and credit card information by e-mail.
Detailed directions
• General Information - Fill in all the requested information in the white spaces below each category. Use the tab
key to jump from one space to the next.
• Type of Organization - Check all categories that apply to your company or organization, and describe in more
detail the type of services or products you provide.
• Place an “X” in the appropriate box to indicate your method of submission and payment.
Credit Card Information: Make sure to enter your credit card information here (MC or Visa). Enter the number, the expiration date, indicate
if it is Mastercard or Visa, and enter the 3 digit verification code on the back of your card. These are the last three numbers in the signature area
of your card.
Submitting and processing your application
When you have completed the application, you must save it, and then send it by e-mail. to [email protected]
Soon after your application is received by THAI, you will receive a confirmation by email.
If you have any questions about the application process, please write to: [email protected]
Thank you for your interest in THAI. We hope to welcome you as an Associate Member !
Associate Member Application
General Information
Type information in the white spaces above each heading
business name
address line 1
address line 2 (optional)
city
state / province
email
website
contact name
zip / postal code
country
telephone
title
Type of Organization (check all that apply)
Educational
Retail
Spa & wellness services
Tourism
Travel / Transportation
Other
Immediately after this sentence, briefly describe the services or products your company offers:
Method of application and payment
Associate Member
$200 USD
Please send this saved application by email
Enter your credit card information below and send this application as an attachment to
[email protected]
One-time registration fee
Credit Card Information
Enter information below, and then save this attachment
Credit card number
Exp. date (mm/yy)
Master Card or Visa?
* The verification number is the last three numbers on the back of your credit card, above your signature.
Verification # *