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Enrolment Form

Take your time...if you make an error you will have to start back at the beginning!
Title*:MrMrsMissDrMs
Name*:
Name To Appear on Certificate (For Introductory Courses write n/a)*:
Address & Post Code:*:
Tel No*:
E-mail*:
Age Group*:
Occupation*:
Title of Course/s You Wish To Enrol On*:
Where Did You Hear About Us?:Healthy PagesGoogleChis UkNatural MattersThe GuildEmbodyChelmsford Magazine/PaperOther
Previous Massage Experience/Anatomy Certificate/Beauty or Holistic Course Certificate?*:
If You are a Massage or Therapy Tutor of any subject:*:
List any Associations/Insurance Companies you are Registered with. If none, please write 'none'*:
Please tick to declare that:*:I have no intention of teaching the subject of the course I am enrolling on at any time
HEALTH DECLARATION*:I do not have any condition that will affect me fully participating in the course. ORI have health problems but will contact you prior to paying the course fee to check that I am able to attend the course
I have read the course details and agree to the TERMS AND CONDITIONS*:YESNO
All of the information I have given is correct*:YESNO
I am paying my course fee by*:On Line Payment Now through PayPal/Credit Card-A £5 SURCHARGE WILL BE ADDED FOR PAYPAL/CARD PAYMENTSI will post a cheque for the full amount to you now- Your place is secured only when payment is receivedOther* (pre-agreed arrangement)
YOUR PLACE IS SECURED ONCE PAYMENT IS RECEIVED. In the case of your chosen course being full, you will be offered a place on the next course or a full refund - Refunds are posted to you BY CHEQUE ONLY
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