Go from Ouch to Ahh at the Student Massage Therapy Clinic


Personal Information Select a Massage Type:

Preferred Day:

Preferred Date: (mm/dd/yyyy)

Preferred Time:

Date of Birth: (mm/dd/yyyy)

First Name:

Last Name:

Address:

City:

State:

ZIP Code:

Phone Number: (ex: 999-888-7777)

Email:

Verify Email:


Billing Information  *Same as above

First Name:

Last Name:

Address:

City:

State:

ZIP Code:

Phone Number: (ex: 999-888-7777)

Card Type:

Card Number: (no spaces)

Expiration Date: (ex: 02/20)

Security Code:  What is this?

Total: $20

You must agree with all terms and conditions before submitting.


For more information call 610-332-6410 or email surffer@northampton.edu