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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
Full Name*:
Name To Appear on Certificate*:
Address*:
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 & Physiology Certificate/Basic Beauty or Holistic Course Certificate?*:
Are You a Massage or Therapy Tutor?*:
List any Holistic/Medical Associations and/or Insurance Companies you are Registered with. If none, please write 'none'*:
I do not have any condition that will affect me fully participating in the course.
I have read the course details and agree to the TERMS AND CONDITIONS
All of the information I have given is correct
I Agree To All of The Above Statements*:YesNo
I am paying my course fee by*:On Line Payment Now through PayPal/Credit CardI will post a cheque for the full amount to you now
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 and not through Paypal
Your place is secured only when payment is received
Once your course fee has been received, confirmation, directions and details of what to bring will be posted to you.
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